Outcomes of Deceased Donor Kidneys Turned Down for Biopsy Results That Were Transplanted Elsewhere

Document Type

Conference Proceeding

Publication Date

1-1-2025

Publication Title

Am J Transplant

Abstract

Background: The number of kidney transplants performed in the US remains insufficient for the number of patients awaiting one. To meet these demands, transplant centers should review their kidney utilization, especially for kidneys that were not accepted. Previous review of kidney offers turned down at our institution revealed a common refusal reason to be unacceptable biopsy results. Some of these organs were subsequently transplanted elsewhere. We analyzed accepted versus turned down biopsied kidneys for Henry Ford Hospital (HFH) to assess our acceptance practices and the need for modifying our acceptance criteria. Methods: Retrospective analysis of OPTN data on deceased donor kidneys offered by Gift of Life Michigan to HFH between 8/2/2022 and 7/19/2024. Only kidneys that were biopsied and ultimately transplanted were included. Biopsied kidneys were classified as either “kidney transplanted by center (KTC)” if accepted and transplanted by HFH and “kidney transplanted elsewhere (KTE)” if turned down by HFH and transplanted elsewhere. Only kidneys turned down for biopsy- specific reasons were included in the analysis. Kidney characteristics and recipient outcomes were compared between the groups. Outcomes of interest were rate of delayed graft function (DGF), recipient 6-month and 1-year serum creatinine (Se Cr), and 6-month and 1-year graft (GS) and patient survival (PS). Results: 103 offers with kidney biopsies were included in the analysis, with 46 in the KTC group and 57 in the KTE group. Selected analysis results are shown in Figure 1. KTE kidneys had a significantly higher percentage of glomerulosclerosis and longer cold ischemia time. Donor characteristics and other biopsy features did not differ significantly between the groups. Recipient outcomes did not differ significantly between the two groups in terms of DGF rate, 6-month and 1-year Se Cr, and 6-month and 1-year GS or PS. Conclusions: While kidney characteristics differed between accepted and passed biopsy kidneys, no significant differences in renal allograft outcomes were noted. Findings of comparable outcomes with KTE kidneys can help reframe a center’s understanding of acceptable organ quality metrics and motivate centers to rethink and expand their acceptance criteria. [Formula presented] DISCLOSURES: Z.Y. Lu: None. A. Yoshida: None. A. Patel: None.

Volume

25

Issue

1

First Page

S97

Last Page

S98

Find It @ Sladen

Share

COinS