title: Donor acute kidney injury and short-term graft outcome in renal transplantation.
abstract: BACKGROUND
  With increased waiting times for kidney transplantation, marginal organs from expanded criteria donors (ECD) are increasingly offered for allocation. In addition to ECD status, donors may have suffered from acute kidney injury (AKI) prior to organ procurement.
  
  
  METHODS
  In this retrospective cohort study, we studied short-term allograft function in 517 kidney transplants performed between the years 2008-2014. Recipients of allografts from deceased organ donors were categorized as standard criteria donors (SCD) or ECD with or without AKI defined by RIFLE criteria.
  
  
  RESULTS
  Of 382 deceased donations, 174 (45.5%) were classified as ECD and 63 (16.5%) fulfilled AKI criteria. Donor creatinine on hospital admission was similar, whereas creatinine before organ procurement differed (p < 0.001). Despite these differences, serum creatinine and eGFR at discharge and after one yr showed only minor differences between kidneys with or without AKI. In multivariate linear regression analyses, donor AKI was not a predictor of one-yr allograft function.
  
  
  CONCLUSIONS
  Given the poor prognosis of dialysis patients and the increase in waiting time, kidneys from SCD and ECD donors with AKI should be allocated for transplantation. In case of ECD donors with AKI, recipients should be informed about the possibility of permanent non-function or early graft loss.
authors: Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
authors: Johannes
authors: J
authors: Jacobi
authors: Dirk
authors: D
authors: Rebhan
authors: Katharina
authors: K
authors: Heller
authors: Joachim
authors: J
authors: Velden
authors: Karl F
authors: KF
authors: Hilgers
authors: Bernd
authors: B
authors: Wullich
authors: Kai-Uwe
authors: KU
authors: Eckardt
authors: Kerstin U
authors: KU
authors: Amann
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000503:physiopathology; D000328:Adult; D064591:Allografts; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000503:physiopathology*; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
keywords: acute kidney injury; allograft survival; expanded criteria donor