Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.

<h4>Background</h4>Favorable long-term and short-term graft survival and patient survival after kidney transplantation (KT) from deceased donors with acute kidney injury (AKI) have been reported. However, few studies have evaluated effects of donor AKI status on graft outcomes after KT i...

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Autores principales:	Jane Ha, Cheol Woong Jung, Sunkyu Choi, Myung-Gyu Kim, Jun Gyo Gwon, Joong Kyung Kim, Chan-Duck Kim, Ji Won Min, Jaeseok Yang, Curie Ahn, Korean Organ Transplantation Registry Study group
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/699000d2a2ce4c1395aae2cdd08daf9e
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spelling	oai:doaj.org-article:699000d2a2ce4c1395aae2cdd08daf9e2021-12-02T20:12:54ZImpact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.1932-620310.1371/journal.pone.0260076https://doaj.org/article/699000d2a2ce4c1395aae2cdd08daf9e2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0260076https://doaj.org/toc/1932-6203<h4>Background</h4>Favorable long-term and short-term graft survival and patient survival after kidney transplantation (KT) from deceased donors with acute kidney injury (AKI) have been reported. However, few studies have evaluated effects of donor AKI status on graft outcomes after KT in Asian population. Thus, the purpose of this study was to evaluate graft function after KTs from donors with AKI compared to matched KTs from donors without AKI using a multicenter cohort in Korea.<h4>Methods</h4>We analyzed a total of 1,466 KTs collected in Korean Organ Transplant Registry between April 2014 and December 2017. KTs from AKI donors (defined as donors with serum creatinine level ≥ 2 mg/dL) and non-AKI donors (275 cases for each group) were enrolled using a 1:1 propensity score matching. Graft outcomes including graft and patient survival, delayed graft function (DGF), rejection rate, and serially measured estimated glomerular filtration rate (eGFR) were evaluated.<h4>Results</h4>After propensity matching, KTs from AKI donors showed higher rate of DGF (44.7% vs. 24.0%, p < 0.001). However, the rejection rate was not significantly different between the two groups (KTs from AKI donors vs. KTs from non-AKI donors). eGFRs measured after 6 months, 1 year, 2 years and 3 years were not significantly different by donor AKI status. With median follow-up duration of 3.52 years, cox proportional hazards models revealed hazard ratio of 0.973 (95% confidence interval [CI], 0.584 to 1.621), 1.004 (95% CI, 0.491 to 2.054) and 0.808 (95% confidence interval [CI], 0.426 to 1.532) for overall graft failure, death-censored graft failure and patient mortality, respectively, in KTs from AKI donors compared to KTs from non-AKI donors as a reference.<h4>Conclusions</h4>KTs from AKI donors showed comparable outcomes to KTs from non-AKI donors, despite a higher incidence of DGF. Results of this study supports the validity of using kidneys from deceased AKI donors in Asian population.Jane HaCheol Woong JungSunkyu ChoiMyung-Gyu KimJun Gyo GwonJoong Kyung KimChan-Duck KimJi Won MinJaeseok YangCurie AhnKorean Organ Transplantation Registry Study groupPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0260076 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jane Ha Cheol Woong Jung Sunkyu Choi Myung-Gyu Kim Jun Gyo Gwon Joong Kyung Kim Chan-Duck Kim Ji Won Min Jaeseok Yang Curie Ahn Korean Organ Transplantation Registry Study group Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.
description	<h4>Background</h4>Favorable long-term and short-term graft survival and patient survival after kidney transplantation (KT) from deceased donors with acute kidney injury (AKI) have been reported. However, few studies have evaluated effects of donor AKI status on graft outcomes after KT in Asian population. Thus, the purpose of this study was to evaluate graft function after KTs from donors with AKI compared to matched KTs from donors without AKI using a multicenter cohort in Korea.<h4>Methods</h4>We analyzed a total of 1,466 KTs collected in Korean Organ Transplant Registry between April 2014 and December 2017. KTs from AKI donors (defined as donors with serum creatinine level ≥ 2 mg/dL) and non-AKI donors (275 cases for each group) were enrolled using a 1:1 propensity score matching. Graft outcomes including graft and patient survival, delayed graft function (DGF), rejection rate, and serially measured estimated glomerular filtration rate (eGFR) were evaluated.<h4>Results</h4>After propensity matching, KTs from AKI donors showed higher rate of DGF (44.7% vs. 24.0%, p < 0.001). However, the rejection rate was not significantly different between the two groups (KTs from AKI donors vs. KTs from non-AKI donors). eGFRs measured after 6 months, 1 year, 2 years and 3 years were not significantly different by donor AKI status. With median follow-up duration of 3.52 years, cox proportional hazards models revealed hazard ratio of 0.973 (95% confidence interval [CI], 0.584 to 1.621), 1.004 (95% CI, 0.491 to 2.054) and 0.808 (95% confidence interval [CI], 0.426 to 1.532) for overall graft failure, death-censored graft failure and patient mortality, respectively, in KTs from AKI donors compared to KTs from non-AKI donors as a reference.<h4>Conclusions</h4>KTs from AKI donors showed comparable outcomes to KTs from non-AKI donors, despite a higher incidence of DGF. Results of this study supports the validity of using kidneys from deceased AKI donors in Asian population.
format	article
author	Jane Ha Cheol Woong Jung Sunkyu Choi Myung-Gyu Kim Jun Gyo Gwon Joong Kyung Kim Chan-Duck Kim Ji Won Min Jaeseok Yang Curie Ahn Korean Organ Transplantation Registry Study group
author_facet	Jane Ha Cheol Woong Jung Sunkyu Choi Myung-Gyu Kim Jun Gyo Gwon Joong Kyung Kim Chan-Duck Kim Ji Won Min Jaeseok Yang Curie Ahn Korean Organ Transplantation Registry Study group
author_sort	Jane Ha
title	Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.
title_short	Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.
title_full	Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.
title_fullStr	Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.
title_full_unstemmed	Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.
title_sort	impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: a nationwide registry-based matched cohort study in korea.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/699000d2a2ce4c1395aae2cdd08daf9e
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Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.

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