By Ziba Kashef
March 11, 2015
Kidneys from deceased donors that have acute injuries are frequently discarded instead of being used for transplant. However, a Yale-led study finds that such kidneys may be more viable than previously thought, and should be considered to meet the growing demand for organ transplants.
Donated kidneys with acute injury are often discarded for fear of poor outcomes such as delayed function and even premature kidney transplant failure. Given the growing need for transplant organs, the Yale-led team embarked on the largest multicenter observational study of its kind to date, including more than 1,600 deceased donors. They examined associations between acute kidney injury (AKI) in donors, rates of kidney discard, and recipient kidney function in the short term as well as six months after transplantation.
As anticipated, the researchers found an association between AKI and organ discard. They also found that injured kidneys were associated with “delayed graft function (DGF),” or the need for continued dialysis support in the first week after transplantation. But unexpectedly, the study did not find a link between deceased-donor kidney injury and poor kidney transplant function six months later.
“What we saw was, with worsening AKI in the donor, the six-month outcome was actually better for recipients who experienced DGF,” said Dr. Isaac E. Hall, investigator in the Program of Applied Translational Research at Yale School of Medicine and first author of the study. Paradoxically, six-month transplant function was worst for those with DGF who had received a donated kidney with no apparent injury.