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Clin Transplant. 2018;32(12):e13431.

Trend, not severity, of acute kidney injury affects graft outcome in deceased donor kidney transplantation.

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제1저자 유미연,유병철 · 교신저자 이하정

PMID 30347464 DOI 10.1111/ctr.13431 IF 1.8 신장내과
소속 (7)
  1. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
  2. Department of Internal Medicine, Soon Chun Hyang University Bucheon Hospital, Bucheon, Korea.
  3. Department of Surgery, Seoul National University Hospital, Seoul, Korea.
  4. Transplantation center, Seoul National University Hospital, Seoul, Korea.
  5. Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea.
  6. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  7. Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Deceased donor kidneys (DDKs) with acute kidney injury (AKI) are difficult to allocate for fear of the expected graft outcome. We aimed to evaluate the impact of donors' AKI severity and trend on graft outcomes in DDK transplantation. This was a retrospective study of DDK transplantation performed from 2005 to 2014. Based on maximum and terminal serum creatinine values before transplantation, the AKI trends were categorized as improving or worsening. Of 413 DDKs, 275 developed AKI: 177 stage 1, 52 stage 2, and 46 stage 3. DDKs with AKI had 212 improving AKI and 63 worsening AKI. Graft outcomes were similar based on AKI stage. Worsening AKI did not affect delayed graft function development; however, it significantly elevated graft failure risk even after adjusting for AKI stage and Kidney Donor Risk Index. Graft survival of the improving group was similar to DDKs with no AKI. This study showed that AKI severity of DDKs did not affect overall graft outcomes. Notably, DDKs with improving AKI showed a similar graft survival rate to DDKs without AKI, although worsening AKI had a worse prognosis. Consideration of the AKI trend, rather than its severity, is needed when DDKs with AKI are allocated.

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Keywords

acute kidney injurydeceased donor kidneysgraft outcomeseveritytrend

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Clinical transplantation · eISSN 1399-0012
전자 출판
2018-11-22
MeSH
Acute Kidney Injury / physiopathology · Adult · Delayed Graft Function / etiology / pathology · Donor Selection / standards · Female · Follow-Up Studies · Graft Rejection / etiology / pathology · Graft Survival · Humans · Kidney Transplantation / adverse effects · Male · Middle Aged · Postoperative Complications · Prognosis · Retrospective Studies · Risk Factors · Tissue Donors / supply & distribution