Tailoring Kidney Transplant Strategies: Unraveling the Impact of Acute Kidney Injury and Preservation Methods Across Different Strata of Kidney Risk
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Wiley
2025
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| author | Daniel M. Kaufman James D. Perkins Nicolae Leca Ramasamy Bakthavatsalam Lena Sibulesky |
| author_facet | Daniel M. Kaufman James D. Perkins Nicolae Leca Ramasamy Bakthavatsalam Lena Sibulesky Daniel M. Kaufman James D. Perkins Nicolae Leca Ramasamy Bakthavatsalam Lena Sibulesky |
| collection | Wiley Open Access |
| contents | Tailoring Kidney Transplant Strategies: Unraveling the Impact of Acute Kidney Injury and Preservation Methods Across Different Strata of Kidney Risk Daniel M. Kaufman James D. Perkins Nicolae Leca Ramasamy Bakthavatsalam Lena Sibulesky Clinical Transplantation ABSTRACTBackgroundThe use of donor kidneys with acute kidney injury (AKI) aims to expand the organ pool, but uncertainty remains regarding their outcomes across different Kidney Donor Profile Index (KDPI) groups and preservation methods.MethodsWe retrospectively analyzed 108 160 deceased donor kidney transplants from the OPTN database, focusing on adult recipients of kidneys from donors with or without AKI between December 2014 and December 2022. Propensity matching was used for each KDPI group (1–20, 21–59, 60–84, and 85–100), comparing donors with AKIN stages 0–1 to AKIN stages 2–3. Cox proportional hazards analysis assessed graft survival by AKIN stages and preservation type.ResultsThe use of AKIN stage 2–3 kidneys significantly increased over the study period. AKIN does not negatively impact graft survival in the KDPI 1–20 group and is linked to improved survival in KDPI 21–59 and 60–84. In the KDPI 85–100 group, AKIN stage 2–3 shows a trend toward increased graft failure. Pump preservation reduces delayed graft function (DGF) across most KDPI groups but does not consistently improve long‐term survival, except in KDPI 85–100.ConclusionTransplantation with AKIN stage 2–3 kidneys is viable, but outcomes vary by KDPI group. Tailored guidelines should consider transplant center capabilities. 10.1111/ctr.70078 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.70078 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70078 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Tailoring Kidney Transplant Strategies: Unraveling the Impact of Acute Kidney Injury and Preservation Methods Across Different Strata of Kidney Risk Daniel M. Kaufman James D. Perkins Nicolae Leca Ramasamy Bakthavatsalam Lena Sibulesky Clinical Transplantation Tailoring Kidney Transplant Strategies: Unraveling the Impact of Acute Kidney Injury and Preservation Methods Across Different Strata of Kidney Risk Daniel M. Kaufman James D. Perkins Nicolae Leca Ramasamy Bakthavatsalam Lena Sibulesky Clinical Transplantation ABSTRACTBackgroundThe use of donor kidneys with acute kidney injury (AKI) aims to expand the organ pool, but uncertainty remains regarding their outcomes across different Kidney Donor Profile Index (KDPI) groups and preservation methods.MethodsWe retrospectively analyzed 108 160 deceased donor kidney transplants from the OPTN database, focusing on adult recipients of kidneys from donors with or without AKI between December 2014 and December 2022. Propensity matching was used for each KDPI group (1–20, 21–59, 60–84, and 85–100), comparing donors with AKIN stages 0–1 to AKIN stages 2–3. Cox proportional hazards analysis assessed graft survival by AKIN stages and preservation type.ResultsThe use of AKIN stage 2–3 kidneys significantly increased over the study period. AKIN does not negatively impact graft survival in the KDPI 1–20 group and is linked to improved survival in KDPI 21–59 and 60–84. In the KDPI 85–100 group, AKIN stage 2–3 shows a trend toward increased graft failure. Pump preservation reduces delayed graft function (DGF) across most KDPI groups but does not consistently improve long‐term survival, except in KDPI 85–100.ConclusionTransplantation with AKIN stage 2–3 kidneys is viable, but outcomes vary by KDPI group. Tailored guidelines should consider transplant center capabilities. 10.1111/ctr.70078 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Tailoring Kidney Transplant Strategies: Unraveling the Impact of Acute Kidney Injury and Preservation Methods Across Different Strata of Kidney Risk |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70078 |