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Excellent graft and patient survival after renal transplantation from donors after brain death with acute kidney injury: a case-control study

BackgroundWhether organs from donors after brain death (DBD) with acute kidney injury (AKI) should be accepted for transplantation is still a matter of debate.MethodsThis was a retrospective, center-based, matched cohort study of 33 renal transplant patients who received a renal allograft from a DBD...

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Main Authors: Benck, Urs Tobias (Author) , Schnülle, Peter (Author) , Krüger, Bernd (Author) , Nowak, Kai (Author) , Riester, Thomas (Author) , Mundt, Heiko (Author) , Birck, Rainer (Author) , Krämer, Bernhard (Author) , Schmitt, Wilhelm (Author)
Format: Article (Journal)
Language:English
Published: 26 October 2015
In: International urology and nephrology
Year: 2015, Volume: 47, Issue: 12, Pages: 2039-2046
ISSN:1573-2584
DOI:10.1007/s11255-015-1127-5
Online Access:Verlag, Volltext: http://dx.doi.org/10.1007/s11255-015-1127-5
Verlag, Volltext: https://link-springer-com.ezproxy.medma.uni-heidelberg.de/article/10.1007/s11255-015-1127-5
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Author Notes:Urs Benck, Peter Schnuelle, Bernd Krüger, Kai Nowak, Thomas Riester, Heiko Mundt, Niklas Lutz, Matthias Jung, Rainer Birck, Bernhard K. Krämer, Wilhelm H. Schmitt
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Summary:BackgroundWhether organs from donors after brain death (DBD) with acute kidney injury (AKI) should be accepted for transplantation is still a matter of debate.MethodsThis was a retrospective, center-based, matched cohort study of 33 renal transplant patients who received a renal allograft from a DBD with AKI. Sixty-five kidney transplants without donor AKI transplanted directly before and after the index transplantation served as controls.ResultsAll AKI donors were classified according to RIFLE criteria: 9.1 % Risk, 54.6 % Injury, and 36.4 % Failure. Mean serum creatinine was 2.41 ± 0.88 mg/dL at procurement and 1.06 ± 0.32 mg/dL on admission. AKI donors had lower 24-h urine production (3.22 ± 1.95 vs. 4.59 ± 2.53 L, p = 0.009) and received more frequently noradrenaline (93.9 vs. 72.3 %, p = 0.02) and/or adrenaline (15.2 vs. 1.5 %, p = 0.02). Recipient and transplant characteristics were similar except a more favorable HLA match in control patients (p = 0.01). Hemodialysis posttransplant was more frequently used in AKI recipients (14/33 [42.4 %] vs. 18/65 [27.7 %], p = 0.17). While significant elevations in serum creatinine were noted in these patients until 10 days after transplantation, this difference lost statistical significance by day 14. One-year graft survival was very similar when comparing the groups (93.6 % [95 % CI 76.8-98.4 %] vs. 90.3 % [95 % CI 79.6-95.5 %], log rank p = 0.58).ConclusionsKidneys from AKI donors can be transplanted with excellent intermediate prognosis and should not be discarded.
Item Description:Gesehen am 31.08.2017
Physical Description:Online Resource
ISSN:1573-2584
DOI:10.1007/s11255-015-1127-5

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