Phenotyping Deceased Donor Acute Kidney Injury to Predict Recipient Outcomes (Ancillary Study Using DDS)

There are over 100,000 patients awaiting a kidney transplant, but only 20% will receive one. This severely unmet demand has motivated the transplant community to find ways to increase the donor pool and to reduce the number of discarded kidneys. Several studies have shown that deceased donor kidneys with temporary damage known as acute kidney injury (AKI), can be safely transplanted. Yet, despite these findings, there is a high number of AKI kidneys being discarded. In an effort to reduce the number of discarded AKI kidneys that can be safely transplanted, we need to better evaluate the quality of donor kidneys with AKI.

Using DonorNet database and the largest multi-centered study of deceased donors in the United States known as the Deceased Donor Study (DDS), we will evaluate whether newer classifications of donor AKI will be able to better predict long-term recipient graft function. We plan to evaluate the classifications by using longitudinal measures of creatinine, etiology of donor AKI as hemodynamic versus structural injury by clinical adjudication, and novel urine repair biomarkers.

Aditya Biswas
Research Assistant, Yale University