@article{6efa04e9e7ab490c8749f12754a2f61b,
title = "Trends in the procurement and discard of kidneys from deceased donors with acute kidney injury",
abstract = "Kidney allocation trends from deceased donors with acute kidney injury (AKI) have not been characterized since initial Kidney Donor Profile Index reporting in 2012 and its use under the revised Kidney Allocation System (KAS) in 2014. We conducted a retrospective analysis of US registry data to characterize kidney procurement and discard trends in deceased donors with AKI, defined by ≥50% or ≥0.3 mg/dl (≥4.0 mg/dl or ≥200% for stage 3) increase in terminal serum creatinine from admission. From 2010 to 2020, 172 410 kidneys were procured from 93 341 deceased donors 16 years or older; 34 984 kidneys were discarded (17 559 from AKI donors). The proportion of stage 3 AKI donors doubled from 6% (412/6841) in 2010 to 12% (1365/11493) in 2020. Procurement of stage 3 AKI kidneys increased from 51% (423/824) to 80% (2183/2730). While discard of stage 3 AKI kidneys increased from 41% (175/423) in 2010 to 44% (960/2183) in 2020, this increase was not statistically significant in interrupted time-series analysis following KAS implementation (slope difference −0.41 [−3.22, 2.4], and level change 3.09 [−6.4, 12.6]). In conclusion, the absolute number of stage 3 AKI kidneys transplanted has increased. Ongoing high discard rates of these kidneys suggest opportunities for improved utilization.",
keywords = "clinical research/practice, donors and donation: deceased, kidney failure/injury, kidney transplantation/nephrology, organ procurement and allocation, translational research/science",
author = "Caroline Liu and Sami Alasfar and Reese, {Peter P.} and Sumit Mohan and Doshi, {Mona D.} and Hall, {Isaac E.} and {Thiessen Philbrook}, Heather and Yaqi Jia and Darren Stewart and Parikh, {Chirag R.}",
note = "Funding Information: The data reported here have been supplied by the United Network for Organ Sharing (UNOS) as the contractor for the OPTN. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the OPTN or the US Government. The content is the responsibility of the authors alone and does not necessarily reflect the view or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. These organizations were not involved in study design, analysis, interpretation, or manuscript creation. Funding Information: The authors of this manuscript have conflicts of interest to disclose as described by the . S. Alasfar reports grant support from CareDx, Shire, and NIH. P.P. Reese reports epidemiology consulting for VALHeath related to identifying patients with chronic kidney disease; Investigator‐initiated and collaborative grants from Merck, Gilead, and AbbVie to the University of Pennsylvania to support trials of transplanting organs from donors with Hepatitis C into Hepatitis C negative recipients; and serves as an Associate Editor of the American Journal of Kidney Disease. S. Mohan reports grant/research support from NIH (NIDDK/NIAID/NIHMD/NIBIB), consulting fees from Angion Pharmaceuticals and serves as Deputy Editor of Kidney International Reports. M.D. Doshi reports salary support from NIDDK. I.E. Hall reports NIH grant support from NCATS (UL1TR002538 and KL2TR002539). C.R. Parikh reports consulting fees from Renalytix (Advisory Board) and Genfit (DSMB), grant/research support from National Institute of Diabetes and Digestion and Kidney Diseases, National Heart, Lung, and Blood Institute. All other co‐authors have no disclosures as described by the . American Journal of Transplantation American Journal of Transplantation Publisher Copyright: {\textcopyright} 2021 The American Society of Transplantation and the American Society of Transplant Surgeons",
year = "2022",
month = mar,
doi = "10.1111/ajt.16920",
language = "English (US)",
volume = "22",
pages = "898--908",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "3",
}