Duration of Dialysis in Acute Kidney Injury Donors and Transplant Outcomes.
Journal
Journal of the American College of Surgeons
ISSN: 1879-1190
Titre abrégé: J Am Coll Surg
Pays: United States
ID NLM: 9431305
Informations de publication
Date de publication:
23 Oct 2023
23 Oct 2023
Historique:
medline:
23
10
2023
pubmed:
23
10
2023
entrez:
23
10
2023
Statut:
aheadofprint
Résumé
Acute kidney injury (AKI) kidneys, including those from donors on dialysis, are often underutilized, although there is increasing data available demonstrating good transplant outcomes. To date, data on the duration of donor dialysis and transplant outcomes are limited. This was a single-center study of deceased donor kidney transplants (DDKT) from 2010 to 2022. The study cohort consisted of recipients of DDKT from donors with AKI and on dialysis. Three groups were identified based on the predetermined interquartile range of donor dialysis duration: a) 1-2 dialysis days, b) 3-4 dialysis days, and c) ≥5 dialysis days. During this period, 765 AKI DDKT were performed, of which 230 were from donors on dialysis. The median dialysis duration was two days with a maximum of 13 days. Across the three groups, there were no differences in recipient age (p=0.23) or dialysis vintage (p=0.70). Donor age (p=0.86) and KDPI (p=0.57) were comparable between the groups. DDKT from donors on dialysis ≥5 days had lower terminal creatinine levels (p=0.003) and longer cold ischemia times (p=0.04). Post-transplant, the median length of hospital stay was 3 days for all groups (p=0.75). There were no differences in delayed graft function occurrence (94.4% vs. 86.8% vs. 92.1%, p=0.19), duration of DGF (p=0.56) or readmissions (p=0.99). At one-year, the estimated glomerular filtration rate (p=0.76), patient survival (p=0.82), or death-censored graft survival (p=0.28) were comparable. Excellent outcomes have been observed in AKI DDKT, including those coming from donors on dialysis. In this small cohort, the duration of donor dialysis did not adversely affect outcomes. Cautious expansion of the donor pool, including donors on dialysis, should be considered given the ongoing organ shortage.
Sections du résumé
BACKGROUND
BACKGROUND
Acute kidney injury (AKI) kidneys, including those from donors on dialysis, are often underutilized, although there is increasing data available demonstrating good transplant outcomes. To date, data on the duration of donor dialysis and transplant outcomes are limited.
STUDY DESIGN
METHODS
This was a single-center study of deceased donor kidney transplants (DDKT) from 2010 to 2022. The study cohort consisted of recipients of DDKT from donors with AKI and on dialysis. Three groups were identified based on the predetermined interquartile range of donor dialysis duration: a) 1-2 dialysis days, b) 3-4 dialysis days, and c) ≥5 dialysis days.
RESULTS
RESULTS
During this period, 765 AKI DDKT were performed, of which 230 were from donors on dialysis. The median dialysis duration was two days with a maximum of 13 days. Across the three groups, there were no differences in recipient age (p=0.23) or dialysis vintage (p=0.70). Donor age (p=0.86) and KDPI (p=0.57) were comparable between the groups. DDKT from donors on dialysis ≥5 days had lower terminal creatinine levels (p=0.003) and longer cold ischemia times (p=0.04). Post-transplant, the median length of hospital stay was 3 days for all groups (p=0.75). There were no differences in delayed graft function occurrence (94.4% vs. 86.8% vs. 92.1%, p=0.19), duration of DGF (p=0.56) or readmissions (p=0.99). At one-year, the estimated glomerular filtration rate (p=0.76), patient survival (p=0.82), or death-censored graft survival (p=0.28) were comparable.
CONCLUSIONS
CONCLUSIONS
Excellent outcomes have been observed in AKI DDKT, including those coming from donors on dialysis. In this small cohort, the duration of donor dialysis did not adversely affect outcomes. Cautious expansion of the donor pool, including donors on dialysis, should be considered given the ongoing organ shortage.
Identifiants
pubmed: 37870238
doi: 10.1097/XCS.0000000000000870
pii: 00019464-990000000-00743
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.