Single kidney transplantation from donors with acute kidney injury: A single‐center experience

Abstract Introduction Despite a severe shortage of organ supply, patients are reluctant to accept organs from deceased donors with AKI, let alone from pediatric AKI donors. Methods We assessed 70 patients who received kidneys from donors with AKI (10 with pediatric and 60 with adult donors) and 176 contemporaneous patients who received kidneys from non‐AKI donors (41 with pediatric and 135 with adult donors) between March 2012 and February 2017 for retrospectively evaluating the clinical outcomes. Results AKI was defined and staging by the RIFLE criteria and pediatric‐modified RIFLE criteria. Median age was 11.00 years IQR (4.50‐14.00 years), and median weight was 25.00 kg (IQR, 17.00‐45.00 kg) for all pediatric donors. Median follow‐up was 8 months (range, 1‐49 months). Adult AKI group had the highest incidence of DGF (35.0% vs 10%, 9.8%, and 19.3%, P = 0.011). There was a significant increase in DGF in higher AKI stages (Risk: 20.7%, Injury: 46.7%, Failure: 50.0%; P = 0.014) among patients with adult donors. No significant differences were noted in 1‐year (100.0%, 95.1%, 98.3%, and 97.8%; P = 0.751) and 3‐year (100.0%, 95.1%, 98.3%, and 97.8%; P = 0.751) patient survival, and 1‐year (90.0%, 97.6%, 98.3%, and 95.6%; P = 0.535) and 3‐year (90.0%, 97.6%, 98.3%, and 95.6%; P = 0.535) graft survival. Conclusion Transplants procured from donors with AKI, particularly pediatric ones, could achieve excellent intermediate‐term clinical outcomes and thus potentially expand the donor pool.