Background

The discard rate of kidneys recovered from deceased donors with acute renal failure (ARF) is higher compared with those without ARF mainly due to the uncertainty regarding short-term and long-term outcomes.

Methods

We retrospectively analyzed 1-year patient, graft, and rejection-free survivals and renal function of transplantations performed with kidneys recovered from deceased donors with or without ARF, defined as serum creatinine level of more than 1.5 mg/dL. We performed multivariable analysis to evaluate whether ARF was an independent risk factor associated with inferior outcomes.

Results

Of a total of 1518 patients, 253 received kidneys from expanded-criteria donors (ECD; with ARF [n= 116] and without ARF [n= 137]) and 1265 from standard-criteria donors (SCD; with ARF [n= 369] and without ARF [n= 896]). The incidence of delayed graft function was higher in ECD (68.1% vs. 58.4%; P= 0.072) and SCD (69.9% vs. 50.6%; P< 0.001) recipients of kidneys with ARF compared with those without ARF, respectively. At 1 year, patient, graft, and rejection-free survivals were not statistically different in SCD or ECD recipients with or without ARF. Renal function at 1 year was similar in recipients of ECD (41.9±26.3 vs. 40.1±21.7 mL/min; P= 0.565) or SCD (50.9±29.9 vs. 53.6±28.5 mL/min; P= 0.131) kidneys with and without ARF, respectively. Compared with kidneys without ARF, receiving a kidney allograft with ARF was not associated with increased risk of death, graft lost, or inferior renal function 1 year after transplantation.

Conclusion

In this cohort of patients, kidneys from deceased donors with ARF provided graft survival and renal function comparable with kidneys from donors without ARF 1 year after transplantation.