Outcomes and factors leading to graft failure in kidney transplants from deceased donors with acute kidney injury—A retrospective cohort study
Due to shortage of donor, kidney transplants (KTs) from donors with acute kidney injury (AKI) are expanding. Although previous studies comparing clinical outcomes between AKI and non-AKI donors in KTs have shown comparable results, data on high-volume analysis of KTs outcomes with AKI donors are lim...
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| creator | Jung, Cheol Woong Jorgensen, Dana Sood, Puneet Mehta, Rajil Molinari, Michele Hariharan, Sundaram Ganoza, Armando Van Der Windt, Dirk Wijkstrom, Martin N Puttarajappa, Chethan M Tevar, Amit D |
| description | Due to shortage of donor, kidney transplants (KTs) from donors with acute kidney injury (AKI) are expanding. Although previous studies comparing clinical outcomes between AKI and non-AKI donors in KTs have shown comparable results, data on high-volume analysis of KTs outcomes with AKI donors are limited. This study aimed to analyze the selection trends of AKI donors and investigate the impact of AKI on graft failure using the United states cohort data. We analyzed a total 52,757 KTs collected in the Scientific Registry of Transplant Recipient (SRTR) from 2010 to 2015. The sample included 4,962 (9.4%) cases of KTs with AKI donors (creatinine ≥ 2 mg/dL). Clinical characteristics of AKI and non-AKI donors were analyzed and outcomes of both groups were compared. We also analyzed risk factors for graft failure in AKI donor KTs. Although the incidence of delayed graft function was higher in recipients of AKI donors compared to non-AKI donors, graft and patient survival were not significantly different between the two groups. We found donor hypertension, cold ischemic time, the proportion of African American donors, and high KDPI were risk factors for graft failure in AKI donor KTs. KTs from deceased donor with AKI showed comparable outcomes. Thus, donors with AKI need to be considered more actively to expand donor pool. Caution is still needed when donors have additional risk factors of graft failure. |
| doi_str_mv | 10.1371/journal.pone.0254115 |
| format | Article |
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Although previous studies comparing clinical outcomes between AKI and non-AKI donors in KTs have shown comparable results, data on high-volume analysis of KTs outcomes with AKI donors are limited. This study aimed to analyze the selection trends of AKI donors and investigate the impact of AKI on graft failure using the United states cohort data. We analyzed a total 52,757 KTs collected in the Scientific Registry of Transplant Recipient (SRTR) from 2010 to 2015. The sample included 4,962 (9.4%) cases of KTs with AKI donors (creatinine ≥ 2 mg/dL). Clinical characteristics of AKI and non-AKI donors were analyzed and outcomes of both groups were compared. We also analyzed risk factors for graft failure in AKI donor KTs. Although the incidence of delayed graft function was higher in recipients of AKI donors compared to non-AKI donors, graft and patient survival were not significantly different between the two groups. We found donor hypertension, cold ischemic time, the proportion of African American donors, and high KDPI were risk factors for graft failure in AKI donor KTs. KTs from deceased donor with AKI showed comparable outcomes. Thus, donors with AKI need to be considered more actively to expand donor pool. Caution is still needed when donors have additional risk factors of graft failure.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0254115</identifier><identifier>PMID: 34437548</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Acute renal failure ; Biology and Life Sciences ; Care and treatment ; Clinical decision making ; Clinical outcomes ; Cohort analysis ; Creatinine ; Data analysis ; Diabetes ; Donors ; Failure analysis ; Graft rejection ; Grafting ; Grafts ; Health aspects ; Health risks ; Hypertension ; Internal medicine ; Ischemia ; Kidney transplantation ; Kidney transplants ; Kidneys ; Medicine ; Medicine and Health Sciences ; Organ transplant recipients ; Patients ; People and places ; Renal failure ; Risk analysis ; Risk factors ; Surgery ; Transplantation ; Transplants ; Variables</subject><ispartof>PloS one, 2021-08, Vol.16 (8), p.e0254115-e0254115</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Jung et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Although previous studies comparing clinical outcomes between AKI and non-AKI donors in KTs have shown comparable results, data on high-volume analysis of KTs outcomes with AKI donors are limited. This study aimed to analyze the selection trends of AKI donors and investigate the impact of AKI on graft failure using the United states cohort data. We analyzed a total 52,757 KTs collected in the Scientific Registry of Transplant Recipient (SRTR) from 2010 to 2015. The sample included 4,962 (9.4%) cases of KTs with AKI donors (creatinine ≥ 2 mg/dL). Clinical characteristics of AKI and non-AKI donors were analyzed and outcomes of both groups were compared. We also analyzed risk factors for graft failure in AKI donor KTs. Although the incidence of delayed graft function was higher in recipients of AKI donors compared to non-AKI donors, graft and patient survival were not significantly different between the two groups. We found donor hypertension, cold ischemic time, the proportion of African American donors, and high KDPI were risk factors for graft failure in AKI donor KTs. KTs from deceased donor with AKI showed comparable outcomes. Thus, donors with AKI need to be considered more actively to expand donor pool. Caution is still needed when donors have additional risk factors of graft failure.</description><subject>Acute renal failure</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Clinical decision making</subject><subject>Clinical outcomes</subject><subject>Cohort analysis</subject><subject>Creatinine</subject><subject>Data analysis</subject><subject>Diabetes</subject><subject>Donors</subject><subject>Failure analysis</subject><subject>Graft rejection</subject><subject>Grafting</subject><subject>Grafts</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Hypertension</subject><subject>Internal medicine</subject><subject>Ischemia</subject><subject>Kidney transplantation</subject><subject>Kidney transplants</subject><subject>Kidneys</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Organ transplant recipients</subject><subject>Patients</subject><subject>People and 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and factors leading to graft failure in kidney transplants from deceased donors with acute kidney injury—A retrospective cohort study</title><author>Jung, Cheol Woong ; Jorgensen, Dana ; Sood, Puneet ; Mehta, Rajil ; Molinari, Michele ; Hariharan, Sundaram ; Ganoza, Armando ; Van Der Windt, Dirk ; Wijkstrom, Martin N ; Puttarajappa, Chethan M ; Tevar, Amit D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-181a5a76f3b30e159befa3b0bc1e4552912c0128797b77fd6df47df9e0d2e1b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute renal failure</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Clinical decision making</topic><topic>Clinical outcomes</topic><topic>Cohort analysis</topic><topic>Creatinine</topic><topic>Data analysis</topic><topic>Diabetes</topic><topic>Donors</topic><topic>Failure analysis</topic><topic>Graft 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Armando</au><au>Van Der Windt, Dirk</au><au>Wijkstrom, Martin N</au><au>Puttarajappa, Chethan M</au><au>Tevar, Amit D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes and factors leading to graft failure in kidney transplants from deceased donors with acute kidney injury—A retrospective cohort study</atitle><jtitle>PloS one</jtitle><date>2021-08-26</date><risdate>2021</risdate><volume>16</volume><issue>8</issue><spage>e0254115</spage><epage>e0254115</epage><pages>e0254115-e0254115</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Due to shortage of donor, kidney transplants (KTs) from donors with acute kidney injury (AKI) are expanding. Although previous studies comparing clinical outcomes between AKI and non-AKI donors in KTs have shown comparable results, data on high-volume analysis of KTs outcomes with AKI donors are limited. This study aimed to analyze the selection trends of AKI donors and investigate the impact of AKI on graft failure using the United states cohort data. We analyzed a total 52,757 KTs collected in the Scientific Registry of Transplant Recipient (SRTR) from 2010 to 2015. The sample included 4,962 (9.4%) cases of KTs with AKI donors (creatinine ≥ 2 mg/dL). Clinical characteristics of AKI and non-AKI donors were analyzed and outcomes of both groups were compared. We also analyzed risk factors for graft failure in AKI donor KTs. Although the incidence of delayed graft function was higher in recipients of AKI donors compared to non-AKI donors, graft and patient survival were not significantly different between the two groups. We found donor hypertension, cold ischemic time, the proportion of African American donors, and high KDPI were risk factors for graft failure in AKI donor KTs. KTs from deceased donor with AKI showed comparable outcomes. Thus, donors with AKI need to be considered more actively to expand donor pool. Caution is still needed when donors have additional risk factors of graft failure.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34437548</pmid><doi>10.1371/journal.pone.0254115</doi><tpages>e0254115</tpages><orcidid>https://orcid.org/0000-0002-0776-8202</orcidid><orcidid>https://orcid.org/0000-0002-9763-6253</orcidid><orcidid>https://orcid.org/0000-0002-2748-1962</orcidid><orcidid>https://orcid.org/0000-0002-3770-8446</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acute renal failure Biology and Life Sciences Care and treatment Clinical decision making Clinical outcomes Cohort analysis Creatinine Data analysis Diabetes Donors Failure analysis Graft rejection Grafting Grafts Health aspects Health risks Hypertension Internal medicine Ischemia Kidney transplantation Kidney transplants Kidneys Medicine Medicine and Health Sciences Organ transplant recipients Patients People and places Renal failure Risk analysis Risk factors Surgery Transplantation Transplants Variables |
| title | Outcomes and factors leading to graft failure in kidney transplants from deceased donors with acute kidney injury—A retrospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T11%3A20%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Outcomes%20and%20factors%20leading%20to%20graft%20failure%20in%20kidney%20transplants%20from%20deceased%20donors%20with%20acute%20kidney%20injury%E2%80%94A%20retrospective%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Jung,%20Cheol%20Woong&rft.date=2021-08-26&rft.volume=16&rft.issue=8&rft.spage=e0254115&rft.epage=e0254115&rft.pages=e0254115-e0254115&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0254115&rft_dat=%3Cgale_plos_%3EA673320956%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2564928607&rft_id=info:pmid/34437548&rft_galeid=A673320956&rft_doaj_id=oai_doaj_org_article_f2e454bb5ab54e4d903ef33333dadad9&rfr_iscdi=true |