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Donation after cardiac death kidneys with low severity pre-arrest acute renal failure

Lookup NU author(s): Dr Colin Wilson, David Rix, Professor Derek Manas, David Talbot

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Abstract

The widening gap between supply and demand for renal transplantation has prompted many centers to use donors after cardiac death. Some of these donors exhibit signs of acute renal failure (ARF) prior to cardiac arrest. Concern has been expressed about poor quality of graft function from such donors. In response to this perception, we reviewed 49 single renal transplant recipients from category III donors after cardiac death between 1998 and 2005, at out center. All kidneys but one had hypothermic machine perfusion and viability testing prior to transplantation. According to the RIFLE criteria, nine recipients had kidneys from donors with "low severity pre-arrest ARF". The remainder of the recipients were used as control group. There was no statistical significant difference in delayed graft function and rejection rates between these two groups. Recipients GFR at 12 months was 44.4 +/- 17.1 and 45.2 +/- 14.7 (mL/min/1.73m(2)) from donors with ARF and without ARF, respectively (p = 0.96). In conclusion, low severity ARF in kidneys from controlled after cardiac death donors can be a reversible condition after transplantation. Short-term results are comparable to the kidneys from same category donors without renal failure, providing that some form of viability assessment is implemented prior to transplantation.

Publication metadata

Author(s): Sohrabi S, Navarro AP, Wilson C, Sanni A, Wyrley-Birch H, Anand DV, Reddy M, Rix D, Jacques B, Manas D, Talbot D

Publication type: Article

Publication status: Published

Journal: American Journal of Transplantation

Year: 2007

Volume: 7

Issue: 3

Pages: 571-575

ISSN (print): 1600-6135

ISSN (electronic): 1600-6143

Publisher: Wiley-Blackwell Publishing, Inc.

URL: http://dx.doi.org/10.1111/j.1600-6143.2006.01639.x

DOI: 10.1111/j.1600-6143.2006.01639.x

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