title: Transplanting Kidneys from Deceased Donors With Severe Acute Kidney Injury.
abstract: Our aim was to determine outcomes with transplanting kidneys from deceased donors with acute kidney injury, defined as a donor with terminal serum creatinine ≥2.0 mg/dL, or a donor requiring acute renal replacement therapy. We included all patients who received deceased donor kidney transplant from June 2004 to October 2013. There were 162 AKI donor transplant recipients (21% of deceased donor transplants): 139 in the standard criteria donor (SCD) and 23 in the expanded criteria donor (ECD) cohort. 71% of the AKI donors had stage 3 (severe AKI), based on acute kidney injury network (AKIN) staging. Protocol biopsies were done at 1, 4, and 12 months posttransplant. One and four month formalin-fixed paraffin embedded (FFPE) biopsies from 48 patients (24 AKI donors, 24 non-AKI) underwent global gene expression profiling using DNA microarrays (96 arrays). DGF was more common in the AKI group but eGFR, graft survival at 1 year and proportion with IF/TA>2 at 1 year were similar for the two groups. At 1 month, there were 898 differentially expressed genes in the AKI group (p-value <0.005; FDR <10%), but by 4 months there were no differences. Transplanting selected kidneys from deceased donors with AKI is safe and has excellent outcomes.
authors: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors: R L
authors: RL
authors: Heilman
authors: Departments of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ.
authors: M L
authors: ML
authors: Smith
authors: Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA.
authors: S M
authors: SM
authors: Kurian
authors: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors: J
authors: J
authors: Huskey
authors: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors: R K
authors: RK
authors: Batra
authors: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors: H A
authors: HA
authors: Chakkera
authors: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors: N N
authors: NN
authors: Katariya
authors: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors: H
authors: H
authors: Khamash
authors: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors: A
authors: A
authors: Moss
authors: Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA.
authors: D R
authors: DR
authors: Salomon
authors: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors: K S
authors: KS
authors: Reddy
mesh_terms: D058186:Acute Kidney Injury / Q000235:genetics / Q000503:physiopathology*; D000328:Adult; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D055815:Young Adult
keywords: clinical research / practice; delayed graft function (DGF); donors and donation: deceased; kidney transplantation / nephrology; molecular biology: mRNA / mRNA expression