Adverse effect of donor vasopressor support on immediate and one-year kidney allograft function.
BACKGROUND
This purpose of this study was to determine if there was a significant difference between the rates of acute tubular necrosis (ATN) and long-term graft survival in renal allografts procured from donors requiring inotropic support (DRIS) and those from donors not requiring inotropic support.


METHODS
Eighty-two consecutive cadaveric renal transplant patients were prospectively followed in our local procurement area, the Delaware Valley Transplant Program. Forty-eight patients received organs from DRIS (> 10 mcg/kg per minute of dopamine, dobutamine, epinephrine, and norepinephrine alone or in combination), and 34 did not.


RESULTS
Allografts from the non-DRIS group had an immediate function rate of 82.4% and a 1-year function rate of 91.2%. In comparison, the DRIS grafts had an immediate function rate of 58.3% and a 1-year function rate of 72.9%. These differences were statistically significant. The mean serum creatinine in the non-DRIS group was 1.46 +/- 0.58 mg/dl, whereas in the DRIS cohort it was 1.89 +/- 0.93 mg/dl.


CONCLUSIONS
Kidneys transplanted from DRIS had significantly (1) poorer immediate function, (2) worse 1-year survival rates, and (3) higher serum creatinine at 1 year. We conclude that recipients receiving organs from donors requiring inotropic support are at a higher risk of developing ATN after surgery and experience reduced 1-year function.
Marshall
R
R
Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033, USA.
Ahsan
N
N
Dhillon
S
S
Holman
M
M
Yang
H C
HC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D003080:Cold Temperature; D003404:Creatinine / Q000097:blood; D004280:Dobutamine / Q000009:adverse effects; D004298:Dopamine / Q000009:adverse effects; D004837:Epinephrine / Q000009:adverse effects; D006085:Graft Survival / Q000187:drug effects*; D006358:Hot Temperature; D006801:Humans; D007511:Ischemia / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply / Q000601:surgery; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009638:Norepinephrine / Q000009:adverse effects; D015995:Prevalence; D012189:Retrospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
D014662:Vasoconstrictor Agents; D004280:Dobutamine; D003404:Creatinine; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine