TY - JOUR
T1 - Successful transplantation of kidneys from deceased donors with acute renal failure
T2 - Three-year results
AU - Anil Kumar, Mysore S.
AU - Khan, Shahid M.
AU - Jaglan, Sandeep
AU - Heifets, Michael
AU - Moritz, Michael J.
AU - Saeed, Muhammad I.
AU - Fyfe, Billie
AU - Sustento-Reodica, Nedjema
AU - Kumar, Aparna
PY - 2006/12
Y1 - 2006/12
N2 - BACKGROUND. Kidneys from deceased donors with acute renal failure (ARF) are generally not accepted for transplantation because of the expected poor outcome. This prospective study examined the utilization of kidneys from donors with ARF for transplantation and the outcomes. METHODS. Fifty-five kidneys from donors with ARF were transplanted. The outcome was compared with concurrent and matched 55 recipients of standard criteria donor (SCD) kidneys and 55 expanded criteria donor (ECD) kidneys. ARF kidneys were accepted from donors aged <50 years, a negative history for kidney disease, and a negative pretransplant biopsy for chronic structural changes. The immunosuppression was similar in all three groups. The outcome measurements included three-year patient and graft survival, biopsy-proven acute rejection (BPAR), subclinical acute rejection (SCAR), and chronic allograft nephropathy (CAN), serum creatinine, and creatinine clearance. RESULTS. Three-year patient and graft survival was 90% and 90% in ARF group, 100% and 89% in SCD group and 83% and 66% in ECD group. BPAR and SCAR were comparable in the groups but CAN was significantly higher in ECD group. Mean serum creatinine levels were 1.9±1.1, 1.9±0.9, and 2.2±1.3 mg/dl and mean creatinine clearances were 66±15, 68±14, and 58±10 mls/minute in ARF, SCD, and ECD groups, respectively (SCD and ARF vs. ECD P=0.04). CONCLUSIONS. Transplantation of kidneys from selected deceased donors with ARF provides comparable survival and function compared to kidneys from non-ARF donors and may be considered for transplantation to expand the donor pool to overcome the current acute shortage of kidneys.
AB - BACKGROUND. Kidneys from deceased donors with acute renal failure (ARF) are generally not accepted for transplantation because of the expected poor outcome. This prospective study examined the utilization of kidneys from donors with ARF for transplantation and the outcomes. METHODS. Fifty-five kidneys from donors with ARF were transplanted. The outcome was compared with concurrent and matched 55 recipients of standard criteria donor (SCD) kidneys and 55 expanded criteria donor (ECD) kidneys. ARF kidneys were accepted from donors aged <50 years, a negative history for kidney disease, and a negative pretransplant biopsy for chronic structural changes. The immunosuppression was similar in all three groups. The outcome measurements included three-year patient and graft survival, biopsy-proven acute rejection (BPAR), subclinical acute rejection (SCAR), and chronic allograft nephropathy (CAN), serum creatinine, and creatinine clearance. RESULTS. Three-year patient and graft survival was 90% and 90% in ARF group, 100% and 89% in SCD group and 83% and 66% in ECD group. BPAR and SCAR were comparable in the groups but CAN was significantly higher in ECD group. Mean serum creatinine levels were 1.9±1.1, 1.9±0.9, and 2.2±1.3 mg/dl and mean creatinine clearances were 66±15, 68±14, and 58±10 mls/minute in ARF, SCD, and ECD groups, respectively (SCD and ARF vs. ECD P=0.04). CONCLUSIONS. Transplantation of kidneys from selected deceased donors with ARF provides comparable survival and function compared to kidneys from non-ARF donors and may be considered for transplantation to expand the donor pool to overcome the current acute shortage of kidneys.
KW - Acute renal failure
KW - Deceased donor kidneys
KW - Kidney transplantation
UR - http://www.scopus.com/inward/record.url?scp=33845918363&partnerID=8YFLogxK
U2 - 10.1097/01.tp.0000250908.62948.8f
DO - 10.1097/01.tp.0000250908.62948.8f
M3 - Article
C2 - 17198251
AN - SCOPUS:33845918363
SN - 0041-1337
VL - 82
SP - 1640
EP - 1645
JO - Transplantation
JF - Transplantation
IS - 12
ER -