Utilization of Donor Kidneys With Acute Kidney Injury in Pediatric Kidney Transplant Recipients.
Acute Kidney Injury
/ blood
Adolescent
Adult
Age Factors
Allografts
/ physiopathology
Child
Cold Ischemia
/ adverse effects
Creatinine
/ blood
Delayed Graft Function
/ epidemiology
Donor Selection
/ standards
Female
Follow-Up Studies
Graft Survival
Humans
Kidney
/ physiopathology
Kidney Transplantation
/ adverse effects
Male
Middle Aged
Registries
Severity of Illness Index
Sex Factors
Tissue Donors
/ statistics & numerical data
Young Adult
Journal
Transplantation
ISSN: 1534-6080
Titre abrégé: Transplantation
Pays: United States
ID NLM: 0132144
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
entrez:
3
4
2020
pubmed:
3
4
2020
medline:
2
10
2020
Statut:
ppublish
Résumé
An elevated terminal creatinine is frequently used as a reason for organ refusal in pediatric kidney transplantation. There is increasing evidence that adults who receive kidneys from donors with moderate to severe acute kidney injury (AKI) have similar outcomes to recipients who receive kidneys from donors with none to mild AKI. We used the Scientific Registry of Transplant Recipients to determine how many pediatric kidney transplant recipients developed delayed graft function (DGF) between 2000 and 2010. When stratified by the donor terminal creatinine, there was no significant difference in the recipient discharge creatinine or the likelihood of developing DGF. In a logistic regression model, older donor age, male donors, and a longer cold ischemia time but not donor terminal creatinine were independent predictors of DGF. There were very few graft loss events documented in this study. Our results are in agreement with previously published data; a high donor terminal creatinine is not significantly associated with DGF in pediatric renal transplant recipients. Additional studies investigating the risk of rejection and long-term graft function are needed before adopting the practice of accepting kidneys with moderate to severe AKI in pediatric kidney transplant recipients.
Sections du résumé
BACKGROUND
An elevated terminal creatinine is frequently used as a reason for organ refusal in pediatric kidney transplantation. There is increasing evidence that adults who receive kidneys from donors with moderate to severe acute kidney injury (AKI) have similar outcomes to recipients who receive kidneys from donors with none to mild AKI.
METHODS
We used the Scientific Registry of Transplant Recipients to determine how many pediatric kidney transplant recipients developed delayed graft function (DGF) between 2000 and 2010.
RESULTS
When stratified by the donor terminal creatinine, there was no significant difference in the recipient discharge creatinine or the likelihood of developing DGF. In a logistic regression model, older donor age, male donors, and a longer cold ischemia time but not donor terminal creatinine were independent predictors of DGF. There were very few graft loss events documented in this study.
CONCLUSIONS
Our results are in agreement with previously published data; a high donor terminal creatinine is not significantly associated with DGF in pediatric renal transplant recipients. Additional studies investigating the risk of rejection and long-term graft function are needed before adopting the practice of accepting kidneys with moderate to severe AKI in pediatric kidney transplant recipients.
Identifiants
pubmed: 32238780
doi: 10.1097/TP.0000000000002827
pii: 00007890-202003000-00029
doi:
Substances chimiques
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
597-602Références
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