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Title: Frequency and outcomes of kidney donation from intensive care patients with acute renal failure requiring renal replacement therapy.
Austin Authors: Sanders, Jo M;Opdam, Helen I ;Furniss, Hayley;Hughes, Peter D;Kanellis, John;Jones, Daryl A 
Affiliation: DonateLife Victoria, Carlton, Victoria, Australia
Department of Nephrology Monash Health and Centre for Inflammatory Diseases, Department of Medicine, Monash University, Melbourne, Australia
Organ and Tissue Authority Canberra, Canberra, ACT, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Royal Melbourne Hospital and Department of Medicine (RMH), University of Melbourne, Melbourne, Australia
School of Public Health and Preventive Medicine Monash University, Melbourne, Australia
Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
Issue Date: Dec-2019 2019-05-13
Publication information: Nephrology 2019; 24(12): 1296-1303
Abstract: Kidney transplantation is the preferred treatment for end-stage renal failure. Unfortunately, donor organ shortages prevent many individuals receiving a renal transplant and there is a need to increase the pool of appropriate donors. The presence of acute kidney injury (AKI) in deceased donors has traditionally been a relative contraindication to renal transplantation, even though renal recovery may be favorable in the absence of chronic renal disease. We undertook an eight-year retrospective observational study of potential deceased organ donors with AKI requiring renal replacement therapy (RRT). We evaluated the rate of successful transplantation as well as short-term and outcomes at a median of 19.5 (13.0-52.7) months after donation. Amongst 1058 consented potential organ donors, 39 patients had AKI requiring RRT, of which 19 became donors (13 not medically suitable, 7 didn't proceed to donation). The median (IQR) donor age was 41 (34-50) years and norepinephrine, epinephrine and vasopressin were given to 18, 14 and 9 donors, respectively. From the 38 donated kidneys 34 were transplanted. The median (IQR) age of recipients was 53 (42.8-58.5) years and they were dialysis free in a median (IQR) of 5.5 (2.3-10.8) days. Only minor abnormalities were found at 3 and 6 month renal biopsies, and 2 patients experienced graft failure in the first 12 months. Amongst deceased donors with AKI receiving RRT and vasoactive medications outcomes of renal transplantation seems acceptable in the absence of pre-existing renal failure and other donor co-morbidity. Such patients may be an important additional source of kidney donation. This article is protected by copyright. All rights reserved.
DOI: 10.1111/nep.13601
ORCID: 0000-0001-6174-2751
PubMed URL: 31081209
Type: Journal Article
Appears in Collections:Journal articles

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