Kidney transplantation from brain death donors with terminal acute renal failure： a report of 26 cases

Objective To explore the effect of kidney transplantation from donation after brain death （DBD） donors with terminal acute renal failure （ARF）. Method The clinical data of kidney transplantation from DBD donors with ARF were retrospectively analyzed, and only standard criteria donors （SCD） were included. The results of kidney transplants from ARF donors were compared with those of kidney transplants from DBD donors with normal renal function （serum creatinine （133 μmol/L） performed from January 2012 to March 2014. Result There were 13 donors with ARF and 27 donors with normal renal function （non-ARF donors）. The ARF donors had significantly higher terminal serum creatinine than the non-ARF donors （394. 9± 176. 8 vs. 75.4 ± 28. 6 μmol/L, P〈0. 001）, but the initial serum creatinine （79. 1 ±17. 2 vs. 71.0 ± 22. 8μmol/L） and the best creatinine clearance rate （128. 3± 33. 0 vs. 129. 8 ± 46. 8 ml/min） of two groups showed no significant difference （P〉0. 05）. Twenty-six recipients received kidney transplants from ARF donors （ARF group） and 54 recipients received kidney transplants from donors with normal renal function （non-ARF group）. There was no significant difference in the incidence of delayed graft function and acute rejection between ARF and non-ARF kidneys （0 vs. 1.9%, and 11.5% vs. 7. 4%, respectively）. The ARF group had significantly lower estimated glomerular filtration rate （eGFR） .at 1st month after transplantation （54. 3 ± 16.9 vs. 62.5 ＋- 14. 2 mL-min-11.73 m-2 , P = 0. 025）, but the eGFRs of two groups were similar at 6th and 12th month after transplantation. During a mean follow-up period of 11.5 months （range 3 to 28 months）, actual patient and graft survival rate for both groups were 100%. Conclusion Kidneys from DBD donors with terminal ARF have excellent short-term outcomes and may represent another potential method to safely expand the donor pool. Key words: Acute renal failure; Donation after brain death;  Kidney transplantation