Organ procurement teams are sometimes leery of accepting kidneys from deceased donors with acute kidney injury (AKI), fearing they will harm the recipients. However, a national study chaired by a Johns Hopkins kidney specialist suggests these fears may be unfounded.

Organ procurement teams are sometimes leery of accepting kidneys from deceased donors with acute kidney injury (AKI), fearing they will harm the recipients. However, a national study chaired by a Johns Hopkins kidney specialist suggests these fears may be unfounded.

In medical chart reviews of 2,430 kidneys transplanted from 1,298 donors—585 (24%) of them with AKI—researchers say they found no significant differences in rates of organ rejection among kidneys from deceased donors with or without AKI.

They also report they found no evidence that factors such as the amount of time an organ is chilled and left without blood supply before transplantation had any impact on recipient outcomes for those who received AKI kidneys.

Improvement of patient safety

Results of the study, published Nov. 20 in the journal Kidney International, suggest that patients in need of kidney transplant could have access to more kidneys—potentially shortening organ waiting list times, the investigators say.

With the field of medicine moving toward a system that focuses on the improvement of patient safety while reducing health care costs, this research is a step forward in the high-value health care movement.

"Our results should add to evidence and reassure the general public and the transplant community that acutely injured deceased-donor kidneys appear to have the same success rates as noninjured kidneys from otherwise similar donors," says Chirag R. Parikh, M.B.B.S., Ph.D., director of the Division of Nephrology at the Johns Hopkins University School of Medicine and senior study author.

"Even transplanted kidneys with the highest severity of AKI did not have worse outcomes, so we should bring these kidneys into the donor pool with confidence," Parikh adds.

An estimated 95,000 Americans are on the national kidney transplant waiting list, according to the U.S. Organ Procurement and Transplantation Networks. Given the organ shortage, says Parikh, the transplant community should pursue measures to increase use of kidneys from deceased donors with AKI.

Physicians worry about patients who develop AKI because they are more likely to have negative long-term consequences, such as chronic kidney disease or premature death, Parikh says. It remains unclear if transplanting a kidney from a donor with AKI would have similar consequences.