Effect of High Creatinemia on Outcome of Cadaveric Renal Transplantation

Kang, Kil Ho; Hur, Kyung Yul; Kim, Jae Joon; Moon, Chul

Abstract

PURPOSE: One of the options to increase number of donor kidneys is to expand acceptable criteria of cadaver donors and to use marginal donor. But these donor acceptability hanve changed with time. In this study, We analyzed the results of renal allo-transplant donated from cadaver with high serum creatinine over 3.0 mg/dL.
METHODS
we analyzed 3 cadaver donors with high serum creatinine (>3.0 mg/dL) among the cadaveric renal transplants operated at Soonchunhyang University Hospital from Jan. 1994 to Dec. 1999, retrospectively.
RESULTS
The level of serum creatinine of 3 cadaver donors were 4.1 mg/dL (donor-A), 5.4 mg/dL (donor- B), 5.1 mg/dL (donor-C) before donation for renal allograft, and 1.1 mg/dL (donor-A), 1.2 mg/dL (donor-B), 1.1 mg/dL (donor-C) on admission. Total 5 patients received renal allografts from 3 cdaveric donors. 4 cases of these received hemodialysis during 2 weeks after operation, and another 1 case received peritoneal dialysis for 6 days after operation, and then hemodialysis for 9 days. 1 case (A-2) of recipients transplanted from donor A did not recovered and the graft kidney was abandoned. The rest 4 cases recovered uneventfully and serum creatinine levels were normailzed. Until recent follow up, serum creatinine levels were normal.
CONCLUSION
In the situation of absolute shortage of donated graft organ, the use of marginal donor is inevitable. Among marginal donor criteria, the acceptance level for high serum creatinine is not confirmed yet. However, brain death patients who previously was healthy but recently deteriorated kidney due to hypotension episodes could be a candidate for transplantation donor. But a large study with long-term follow-up is required in order to expand their clinical indication.