Successful transplantation of kidneys from deceased donors with acute renal failure

Three-year results

Mysore S. Anil Kumar, Shahid M. Khan, Sandeep Jaglan, Michael Heifets, Michael J. Moritz, Muhammad Irfan Saeed, Billie Fyfe, Nedjema Sustento-Reodica, Aparna Kumar

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1640-1645
Number of pages6
JournalTransplantation
Volume82
Issue number12
DOIs
StatePublished - Dec 1 2006

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Acute Kidney Injury
Kidney Transplantation
Tissue Donors
Kidney
Creatinine
Graft Survival
Biopsy
Allografts
Transplantation
Kidney Diseases
Serum
Immunosuppression
Renal Insufficiency

Keywords

  • Acute renal failure
  • Deceased donor kidneys
  • Kidney transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Successful transplantation of kidneys from deceased donors with acute renal failure : Three-year results. / Anil Kumar, Mysore S.; Khan, Shahid M.; Jaglan, Sandeep; Heifets, Michael; Moritz, Michael J.; Saeed, Muhammad Irfan; Fyfe, Billie; Sustento-Reodica, Nedjema; Kumar, Aparna.

In: Transplantation, Vol. 82, No. 12, 01.12.2006, p. 1640-1645.

Research output: Contribution to journalArticle

Anil Kumar, MS, Khan, SM, Jaglan, S, Heifets, M, Moritz, MJ, Saeed, MI, Fyfe, B, Sustento-Reodica, N & Kumar, A 2006, 'Successful transplantation of kidneys from deceased donors with acute renal failure: Three-year results', Transplantation, vol. 82, no. 12, pp. 1640-1645. https://doi.org/10.1097/01.tp.0000250908.62948.8f
Anil Kumar, Mysore S. ; Khan, Shahid M. ; Jaglan, Sandeep ; Heifets, Michael ; Moritz, Michael J. ; Saeed, Muhammad Irfan ; Fyfe, Billie ; Sustento-Reodica, Nedjema ; Kumar, Aparna. / Successful transplantation of kidneys from deceased donors with acute renal failure : Three-year results. In: Transplantation. 2006 ; Vol. 82, No. 12. pp. 1640-1645.
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abstract = "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.",
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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 Irfan

AU - Fyfe, Billie

AU - Sustento-Reodica, Nedjema

AU - Kumar, Aparna

PY - 2006/12/1

Y1 - 2006/12/1

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

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