Hiroshima J. Med. Sci.
Vol. 53, No. 1, 7`PP, March, 2004
Seiji MARUBAYASHI 1), Hirotaka TASHIRO 2), Hideki OHDAN 2), Daisuke TOKITA 2), Hidetaka HARA 2), Takashi ONOE 2), Teruhiko KITAYAMA 2), Keisuke HAYAMIZU 2), Toshimasa ASAHARA 2), Shigehiro DOI 1), Satoshi OKUMOTO 1), Yoshihiko TANIGUCHI 1), Yasuhiko FUKUDA 3) and Kiyohiko DOHI 3)
1) Department of Blood Purification, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan
2) Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan
3) Department of General Surgery, Hiroshima Prefectural Hospital, Ujina Kanda 1-5-54, Minamiku, Hiroshima 734-8530, Japan
Key words: Renal Transplantation, Non-heart-beating donors, Early graft function
This study was performed to analyze postoperative courses and complications, retrospectively, following transplants from non-heart-beating donors and to examine the correlation between early graft function and clinical parameters. We experienced 11 cases of kidney transplants from non-heart-beating donors during the period from April 1995 to May 2003. Warm ischemic time was less than 30 min in all cases, and total ischemic time ranged from 8.4 hours to 27.9 hours. Rejection reactions occurred in seven cases, two of which were vascular rejections. Infectious disease complications included CMV in two cases, interstitial pneumonia in one case and fungal infection in one case. One patient died from interstitial pneumonia, and three patients had to be restarted on dialysis due to loss of function of the grafted kidney. The remaining seven patients all made full recoveries. All of the 16 patients who underwent living related kidney transplantations during the same period made full recoveries. Both the donorŐs gender and the latest creatinine level of the donor influenced the posttransplant dialysis period. The posttransplant dialysis period significantly influended the creatinine level one month after transplant. These results suggest that patients who undergo kidney transplants from non-heart-beating donors have higher rates of complications than patients who undergo living related kidney transplantation. It is important that, in cases where the donorŐs creatinine level is high, especially when the donor is male, the kidney is carefully retrieved and transported to the recipent hospital to shorten the ischemic period as much as possible.
Running title: Kidney Transplants from Non-Heart-Beating Donors