Deceased Donor Kidney Transplantation from Donors with Acute Kidney Injury Based On RIFLE, AKIN, and KDIGO Criteria: A Meta-Analysis

Abstract

Introduction

 Using kidneys from deceased donors with acute kidney injury (AKI) is one of the options to expand the donor pool. Several studies have reported on the transplantation of kidneys with donor AKI with favorable outcomes. This study aimed to demonstrate the outcomes of kidney transplantation cases where deceased donors developed AKI before organ procurement and show the comparison between the AKI and non-AKI donor kidneys.

 Material and methods

 A systematic literature search and meta-analysis of the PubMed and ClinicalTrials.gov registry was performed. A three-stage independent screening method was applied. The inclusion criteria for this review were published prospective, retrospective, clinical trials, and systematic reviews studies using AKI donor kidneys and compared them to non-AKI donor kidneys.

eGFR, serum creatinine level, delayed graft function rate, length of stay and graft, and patient survival rate were demonstrated.

Results

 18 articles that had AKI kidney functions after transplantation and patients and graft survival rate were included in this meta-analysis. DGF rate was significantly higher in recipients of AKI donor kidneys as expected (P = < 0.00001). Acute rejection, allograft, and patient one and five-year survival rates were comparable, and the difference was not significant.

 Conclusion

 Our systematic review shed light on the importance of considering AKI donor kidneys as a source of donor pool expansion and provides more evidence that transplantation of kidneys with AKI has comparable results to non-AKI kidneys, and transplant centers may consider using AKI kidneys more often, which results in kidney donor pool.