In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 3 ( 2021-3-25), p. e0249000-
Abstract:
The need for kidney transplantation drives efforts to expand organ donation. The decision to accept organs from donors with acute kidney injury (AKI) can result in a clinical dilemma in the context of conflicting reports from published literature. Material and methods This observational study included all deceased donor kidney transplants performed in Australia and New Zealand between 1997 and 2017. The association of donor-AKI, defined according to KDIGO criteria, with all-cause graft failure was evaluated by multivariable Cox regression. Secondary outcomes included death-censored graft failure, death, delayed graft function (DGF) and acute rejection. Results The study included 10,101 recipients of kidneys from 5,774 deceased donors, of whom 1182 (12%) recipients received kidneys from 662 (11%) donors with AKI. There were 3,259 (32%) all-cause graft failures, which included 1,509 deaths with functioning graft. After adjustment for donor, recipient and transplant characteristics, donor AKI was not associated with all-cause graft failure (adjusted hazard ratio [HR] 1.11, 95% CI 0.99–1.26), death-censored graft failure (HR 1.09, 95% CI 0.92–1.28), death (HR 1.15, 95% CI 0.98–1.35) or graft failure when death was evaluated as a competing event (sub-distribution hazard ratio [sHR] 1.07, 95% CI 0.91–1.26). Donor AKI was not associated with acute rejection but was associated with DGF (adjusted odds ratio [OR] 2.27, 95% CI 1.92–2.68). Conclusion Donor AKI stage was not associated with any kidney transplant outcome, except DGF. Use of kidneys with AKI for transplantation appears to be justified.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0249000
DOI:
10.1371/journal.pone.0249000.g001
DOI:
10.1371/journal.pone.0249000.g002
DOI:
10.1371/journal.pone.0249000.g003
DOI:
10.1371/journal.pone.0249000.g004
DOI:
10.1371/journal.pone.0249000.g005
DOI:
10.1371/journal.pone.0249000.g006
DOI:
10.1371/journal.pone.0249000.t001
DOI:
10.1371/journal.pone.0249000.t002
DOI:
10.1371/journal.pone.0249000.t003
DOI:
10.1371/journal.pone.0249000.s001
DOI:
10.1371/journal.pone.0249000.s002
DOI:
10.1371/journal.pone.0249000.s003
DOI:
10.1371/journal.pone.0249000.s004
DOI:
10.1371/journal.pone.0249000.s005
DOI:
10.1371/journal.pone.0249000.s006
DOI:
10.1371/journal.pone.0249000.s007
DOI:
10.1371/journal.pone.0249000.s008
DOI:
10.1371/journal.pone.0249000.s009
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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