Background: Donor rhabdomyolysis may constrain kidney utilization due to anticipated unfavorable graft outcomes-especially in combination with acute kidney injury (AKI). There is a paucity of empiric data to inform organ acceptance decision-making.
Methods: A single-center retrospective cohort study of adult transplant recipients of deceased-donor kidneys with reported donor creatine phosphokinase (CPK) levels was conducted between 2014 and 2020. Recipients of CPK ≥ 1000 U/L kidneys were propensity matched to CPK < 1000 recipients according to outcome-predictive baseline covariates, except AKI.
Results: A total of 254 kidney transplants were propensity matched into CPK ≥ 1000 (n = 90) versus CPK < 1000 (n = 90) groups. Transplant outcomes with high versus low CPK kidneys were similar in terms of delayed graft function (P = 0.64), 1-year estimated glomerular filtration rate < 25th percentile (P = 0.69) and mean (P = 0.58), and time to all-cause graft failure (P = 0.58). There was no interaction between AKI and high CPK for these outcomes. Extreme CPK thresholds as high as > 8672 U/L were not associated with overall graft survival in the unmatched sample (P = 0.81).
Conclusions: In a single center study, donor rhabdomyolysis was not associated with short-term kidney transplant graft outcomes, nor was there an additive effect of AKI. However, studies with greater CPK and AKI severity and longer follow-up are warranted.
Keywords: acute kidney injury; creatine phosphokinase; delayed graft function; graft survival; kidney transplant; rhabdomyolysis.
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.