Disclosures: Parikh reports consulting fees from Renalytix (Advisory Board) and Genfit (Data and Safety Monitoring Board), grant/research support from National Institute of Diabetes and Digestion and Kidney Diseases, National Heart, Lung and Blood Institute.
December 29, 2021
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Number of stage 3 AKI kidneys transplanted increased from 2010 to 2020

Disclosures: Parikh reports consulting fees from Renalytix (Advisory Board) and Genfit (Data and Safety Monitoring Board), grant/research support from National Institute of Diabetes and Digestion and Kidney Diseases, National Heart, Lung and Blood Institute.
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From 2010 to 2020, the number of stage 3 AKI kidneys transplanted has increased, according to data published in American Journal of Transplantation.

Further, the number of transplant centers using stage 3 AKI kidneys increased across the decade.

donor kidney
Source: Adobe Stock

“The U.S. kidney transplantation system has evolved significantly within the past decade to improve allocation policies and address the growing kidney transplant waitlist,” Chirag R. Parikh, MD, MBBS, PhD, professor of medicine and director of the division of nephrology at Johns Hopkins University School of Medicine, and colleagues wrote. “We undertook this study to characterize temporal trends in the allocation of kidneys from deceased donors with AKI in the setting of the kidney donor profile index (KDPI) introduction and the Kidney Allocation System (KAS) implementation.”

In a retrospective analysis, researchers evaluated 2010-2020 DonorNet data of 93,341 deceased donors from the Organ Procurement and Transplantation Network (OPTN) system. Researchers calculated how many kidneys were donated, discarded and used, then stratified trends by stages of AKI.

From 93,341 donors, 172,410 kidneys were procured and 34,984 were discarded. A total of 36% donors experienced AKI, and the proportion remained consistent between 2010 and 2020. However, donors with stage 3 AKI increased from 6% in 2010 to 12% in 2020.

While the number of kidneys procured with stage 1 and 2 AKI remained similar throughout the decade, stage 3 AKI kidneys increased from 51.3% in 2010 to 80% in 2020. Analyses revealed the number of centers that utilize stage 3 AKI kidneys increased from 36% in 2010 to 56% in 2020.

Stage 3 AKI kidneys were discarded less (41.4%) from 2010 to 2012 before increasing 44% to the end of 2020. Researchers correlated this increase with the introduction of KDPI in 2012 and KAS in 2014.

“We found statistically insignificant increases in the procurement and discard rates of stage 3 AKI kidneys following implementation of KAS. Although the discard rate has increased, the absolute number of stage 3 AKI kidneys transplants has increased and the number of transplant centers utilizing stage 3 AKI kidneys has increased from 33% to over half,” Parikh and colleagues wrote. “This may reflect increased center adoption and experience with stage 3 AKI kidneys with continued room for improvement in organ utilization.”