Successful Transplantation of Kidneys from a Donor with Myoglobinuric Acute Renal Failure

Abstract

The shortage of donor organs is reflected in the growing number of patients on the waiting list for kidney transplantation worldwide. It seems to be sensible to expand the scarce donor pool by the cautious use of extended donor criteria. Kidneys from a 21-year-old deceased donor road traffic accident victim who suffered acute renal failure (ARF) due to myolysis were transplanted. Both transplantations were successful after an initial period of delayed graft function. Therefore, kidneys from deceased donors with ARF should not be excluded for transplantation in general.

Kidney transplantation from donors with rhabdomyolysis and acute renal failure

“…Rhabdomyolysis and acute renal failure (ARF) may be considered a contraindication for kidney donation, especially when the donor is anuric . There are a few case reports in the literature of kidney transplantation from donors with rhabdomyolysis, but the long‐term renal function of these grafts is unknown . Here, we report our initial experience of kidney transplantation from donors with severe rhabdomyolysis and ARF.…”

“…8,9 There are a few case reports in the literature of kidney transplantation from donors with rhabdomyolysis, but the long-term renal function of these grafts is unknown. [9][10][11][12][13] Here, we report our initial experience of kidney transplantation from donors with severe rhabdomyolysis and ARF.…”

Transplant of Kidneys from a Small Pediatric Donor with Severe Rhabdomyolysis

“…Despite ischemic damages to the renal tubule, patients with rhabdomyolysis that do not expire usually recover renal function in 10 to 14 days (3). Kidney transplants from adult donors with rhabdomyolysis have been reported to recover acceptable function (3,4). In these reports, donor CPK levels ranged from 6099 to 52,048 U/L (3,4).…”

“…Kidney transplants from adult donors with rhabdomyolysis have been reported to recover acceptable function (3,4). In these reports, donor CPK levels ranged from 6099 to 52,048 U/L (3,4). Although delayed graft function occurred in approximately 42% of reported cases, all kidneys ultimately functioned in the short-term.…”

Excellent outcome using “impaired” standard criteria donors with elevated serum creatinine

“…Among the strategies employed to address the scarcity of organs for transplant is the use of kidneys from non‐standard donors. These include older donors, those with a history of diabetes, hypertension or vascular disease, and those with elevated serum creatinine (S.Cr) (1, 3). Previous studies have reported that an elevated donor S.Cr is only important in predicting the short‐term graft survival (87% survival at one yr) (4).…”