The role of donor and recipient factors in initial renal graft non-function.
ATN is a deleterious problem in the outcome of kidney transplantation. This complication is usually related to multiple factors including donor parameters, surgical technique, ischemic time, and recipient variables. In order to develop prophylactic measures, out of 430 kidney transplants performed in our Department, a series of 90 consecutive cadaveric renal allografts has been considered in this study. The overall incidence of IGNF was 23/90 (25.5%). Kidneys from MOD revealed a lower rate of IGNF (7/35 = 20%) when compared with organs from SOD (16/55 = 29%, P = NS). No difference was noted when kidneys were removed together with heart and/or liver and/or pancreas. Out of the donor factors, only CID was significant (17 +/- 9 hours in IGNF v 11 +/- 10 hours in patients with IGF, P = less than .05). Analysis of data concerning the fate of paired kidneys revealed two cases of IGNF in both kidneys from the same donor v 14 cases of IGNF in only one of the two paired grafts (P = NS). We conclude that: 1. Donor factors are clearly associated with a minority of IGNF. 2. The introduction of multiorgan procurement programs does not complicate early function. 3. Recipient factors (immunological events and intraoperative fluid management) provides important additive effects on initial graft nonfunction.
Belli
L S
LS
Department of Surgery, Niguarda CaGranda Hospital, Milan, Italy.
De Carlis
L
L
Del Favero
E
E
Civati
G
G
Brando
B
B
Romani
F
F
Aseni
P
P
Rondinara
G F
GF
Palmieri
B
B
Meroni
A
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000961:Antilymphocyte Serum / Q000032:analysis; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008875:Middle Aged; D009926:Organ Preservation; D016035:Pancreas Transplantation; D012189:Retrospective Studies; D014019:Tissue Donors
D000961:Antilymphocyte Serum