Abstract 4146232: Kidney Transplant Outcomes From Deceased Donors Who suffered Acute Kidney Injury: Systematic Review and Meta-Analysis

Background: Kidney transplant is the most common transplanted organ in the world. However, the efficacy of transplants from deceased donors with acute kidney injury (AKI) before transplantation is a matter of debate. For this reason, we performed a meta-analysis to assess the outcomes of kidney transplants from deceased donors with AKI when compared to non-AKI deceased donors. Methods: We systematically searched MedLine, Embase, and Cochrane databases for studies comparing kidney transplants from deceased donors with AKI compared to those without AKI. The endpoints were Acute Rejection (AR), Delayed Graft Function (DGF), and Graft Failure (GF). We calculated event prevalence with risk ratios for binary outcomes, along with 95% confidence intervals (CI). Statistical analysis was performed using R version 4.3.2. A random-effects model was used for all outcomes, and heterogeneity was assessed with Cochrane's Q and I2 statistics. Results: We included 10 retrospective cohort studies, that comprised 68,619 patients, where 33,623 (49%) were females after we disposed of major overlapping populations. We found that the overall risk of AR, DGF, and GF to be respectively (RR 0.93; 95% CI: 0.88 to 0.98; p<0.01; Figure 1), (RR 1.36; 95% CI: 0.98 to 1.90; p=0.07; Figure 2) and (RR 0.93; 95% CI: 0.84 to 1.03; p=0.16; Figure 3). The subgroup of stage 3 AKI showed an increase in the risk of DGF (RR 1.68; 95% CI: 1.28 to 2.19; p<0.01; Figure 2) for these donors. Conclusion: In our Meta-analysis, we found that there’s no difference in the outcomes between AKI and non-AKI deceased donors. However, there is an increase in the risk of DGF in organs from deceased donors with stage 3 AKI. More studies are warranted to assess these results.