Impact of deceased donor acute kidney injury (AKI) on renal transplant outcomes

Nozdrin, M; Bellini, MI; Selyanina, M; Nozdrina, M; Vivek, K; Mihalikova, S; Papalois, V

Journal article : Review

Impact of deceased donor acute kidney injury (AKI) on renal transplant outcomes

Abstract:: AimsDonor AKI is a common reason for discarding deceased donor kidneys due to uncertainty regarding transplant outcomes. Our study investigated the effect of AKI in donor kidneys on post-transplantation outcomes.MethodsMedline, Embase, Cochrane and Web of Science were searched. Risk of bias assessment was performed. 2984 studies were identified by the search, 34 met the inclusion criteria. A total of 103,529 kidney transplants were analysed, 97,165 (94 %) with and 6364 (6 %) without donor AKI.ResultsThere was no significant difference between recipients of grafts from donors with terminal serum creatinine >2.0 mg/dl and < 2.0 mg/dl in 1 year serum creatinine (MD: -0.01, CI: -0.09-0.07, P = 0.84), 1 year patient survival (RR: 0.99, CI: 0.96-1.02, P = 0.52), as well as in 1 year (RR: 1.01, CI: 0.98-1.03, P = 0.61) and 5 year (RR: 0.99, CI: 0.94-1.04, P = 0.63) graft survival. DGF was the only parameter significantly worse in recipients of grafts from donors with terminal serum creatinine >2.0 than to non-AKI recipients (RR: 1.89, CI: 1.64-2.17, P < 0.01). In studies that compared the severity of AKI stage using the AKIN criteria, there was no significant difference in 1 year post-transplantation serum creatinine even between recipients of grafts from the most severe AKI stage (AKIN3) and the non-AKI group (AKIN0) (MD: -0.01, CI:-0.17-0.16, P = 0.92).ConclusionsDonor AKI is associated with a higher incidence of DGF but has no effect on post-transplant patient and graft survival and, based on this analysis, should not be a sole reason for discarding kidneys.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Nozdrin, M., Bellini, M. I., Selyanina, M., Nozdrina, M., Vivek, K., Mihalikova, S., & Papalois, V. (2025). Impact of deceased donor acute kidney injury (AKI) on renal transplant outcomes. Surgery Open Science, 29, 7–21.

MLA Style

Nozdrin, M, et al. “Impact of Deceased Donor Acute Kidney Injury (AKI) on Renal Transplant Outcomes.” Surgery Open Science, vol. 29, 2025, pp. 7–21.

Chicago Style

Nozdrin, M, MI Bellini, M Selyanina, et al. 2025. “Impact of Deceased Donor Acute Kidney Injury (AKI) on Renal Transplant Outcomes.” Surgery Open Science 29: 7–21.
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