Introduction: Acute kidney injury (AKI) is a concern when deceased donors are evaluated. AKI in donors is related with a discard rate of 30% because a potential of graft failure. Several studies have demonstrated effective use of these kidneys. With the need to expand the donor pool, we did the analysis in our center to determine the association of donor AKI and outcomes in time follow-up of 6 months.
Materials and Methods: Observational study, retrospective in a single center. Descriptive analyses included medians (interquartile range) for quantitative variables, absolute frequencies for qualitative variables. Clinical characteristics and outcomes were compared in groups with and without AKI using Kruskal-Wallis or chi square test. Statistical tests and confidence intervals were two-side with a p value of 0.05. 
Results: From June 2021 to July 2023, we registered 78 kidney transplants from deceased donor with donor´s median age was 37 years old (23-49), 74.4% were male and 12 (15.4%) were diagnosed with Diabetes Mellitus type 2. The main cause of death was head trauma in 61 (78.2%). When categorized by AKI-KDIGO, 10 (66.7%), 6 (25%) and 2 (8.3%) donors had stage 1,2 and 3, respectively. We found that the median of creatinine (mg/dL) was higher in the deceased donor with AKI, [2 (1.7-2.2) vs 0.7 (0.4-1)], and 6 (7.7%) donors in this group, also had a cardiac arrest event. Furthermore, the median of cold ischemic time (min) was higher in donors with AKI [825 (765-944) vs 786 (686-960), p= 0.269)]; 12 (70.6%) patients that receive graft with AKI had delayed graft function (DGF) and 7 (38.9%) continued with replacement renal therapy as outpatient. Despite the concern of DGF, we did not find differences in the estimated glomerular filtration rate, acute rejection, or graft failure in 6 moths of follow-up. Finally, in our regression model we found that for every minute of cold ischemic time (HR 1.005 [1.001-1.008]; p<0.01) and having received a kidney with AKI (HR 3.66 [1.07-12.50]; p<0.38) was associated with DGF.
Conclusion: Our findings indicate that utilizing kidneys from donors with AKI do not have adverse effect in the outcomes in recipients during 6 months of follow-up. Our analysis led to consider a change in logistics to decrease the cold ischemic time in our donors. Also, we should continue with the research to do better practices of preservation and management of DGF in the recipients.