Donor rhabdomyolysis, acute kidney injury, and kidney transplant outcomes

Zaphiros, Nikolas; Nie, Jing; Noyes, Katia; Luong, Albert; Kayler, Liise K.

doi:10.1111/ctr.14569

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Although more patients desire deceased donor kidney transplantation, the number of organ donations in Japan is 0.61 per million population, which is extremely low compared to that in other countries [2]. Kidneys from donors with rhabdomyolysis who develop AKI may be considered ineligible for transplantation because of their dark red appearance and concerns about posttransplantation renal dysfunction [3]. However, there are some reports that kidneys donated by donors with rhabdomyolysis exhibit good renal function [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

A Case of Kidney Transplantation from a Deceased Donor with Acute Kidney Injury due to Rhabdomyolysis

Takada

Hotta

Moriya

et al. 2023

Nephron

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Acute kidney injury (AKI) due to rhabdomyolysis occurs because of renal ischemia or acute tubular necrosis due to the deposition of myoglobin casts in the renal tubules. Donors with AKI due to rhabdomyolysis are not contraindication for transplantation. However, the dark red kidney raises concerns about renal hypofunction or primary nonfunction after transplantation. We report the case of a 34-year-old man with a 15-year history of hemodialysis for chronic renal failure due to congenital anomalies of the kidney and urinary tract. The patient received a renal allograft from a young woman who suffered cardiac death. The serum creatinine (sCre) level of the donor at the time of transport was 0.6 mg/dL, and renal ultrasonography revealed no abnormalities in renal morphology or blood flow. Her serum creatine kinase level increased to 57,000 IU/L 58 h after femoral artery cannulation, and sCre level worsened to 1.4 mg/dL, suggesting AKI due to rhabdomyolysis. However, since the urine output of the donor was maintained, the sCre elevation was thought to be nonproblematic. The allograft had a dark red appearance at the time of procurement. The perfusion of the isolated kidney was good, but the dark red color did not improve. A 0-h biopsy showed flattening of the renal tubular epithelium and absence of the brush border and myoglobin casts in 30% of the renal tubules. Rhabdomyolysis-related tubular damage was diagnosed. Hemodialysis was discontinued on postoperative day 14. Twenty-four days after the operation, the transplanted kidney function progressed favorably (sCre 1.18 mg/dL), and the patient was discharged. Protocol biopsy 1 month after transplantation showed disappearance of myoglobin casts and improvement in renal tubular epithelial damage. The patient’s sCre level was approximately 1.0 mg/dL 24 months after transplantation, and he is doing well without complications.

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Section: Discussionmentioning

confidence: 99%

A Case of Kidney Transplantation from a Deceased Donor with Acute Kidney Injury due to Rhabdomyolysis

Takada

Hotta

Moriya

et al. 2023

Nephron

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Histopathological Features and Role of Allograft Kidney Biopsy Among Recipients With Prolonged Delayed Graft Function: A Review

Swanson,

Zhong,

Mandelbrot

et al. 2024

Transplantation

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Delayed graft function (DGF) is an early posttransplant complication predictive of adverse outcomes. This “acute kidney injury of transplantation” is often defined as allograft dysfunction requiring renal replacement within 7 d posttransplantation. DGF is an important area of study because it is emerging with efforts to expand the donor pool and address the supply-demand gap in kidney transplantation. DGF is often caused by severe kidney injury mechanisms because of multiple donors, recipients, and immunologic factors. The role of kidney biopsy, particularly in prolonged DGF, is an ongoing area of research and inquiry for clinicians and researchers alike to better define, manage, and predict outcomes of this early posttransplant event. This review aims to provide an in-depth, comprehensive summary of the literature to date on the histopathology of DGF and the role of kidney transplant biopsies in prolonged DGF.

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Donor rhabdomyolysis, acute kidney injury, and kidney transplant outcomes

Cited by 2 publications

References 22 publications

A Case of Kidney Transplantation from a Deceased Donor with Acute Kidney Injury due to Rhabdomyolysis

A Case of Kidney Transplantation from a Deceased Donor with Acute Kidney Injury due to Rhabdomyolysis

Histopathological Features and Role of Allograft Kidney Biopsy Among Recipients With Prolonged Delayed Graft Function: A Review

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