title: Different clinicopathological courses of two recipients of kidneys retrieved from the same non-heart beating donor.
abstract: We report the clinicopathological courses of two recipients of kidneys retrieved from the same non-heart beating donor (NHBD). A 52-year-old man received a renal transplant from an NHBD. The donor was a 66-year-old woman who died of subarachnoid haemorrhage. The recipient was immunosuppressed by basiliximab, tacrolimus (TAC), mycophenolate mofetil (MMF), methyl prednisolone (MP), and antilymphocyte globulin (ALG). On post-operative day (POD) 21, haemodialysis therapy was withdrawn, however, their serum creatinine (s-Cr) level failed to improve. Four transplant biopsies were performed (1 h and POD 46, 74, and 114). The biopsy showed tubular degeneration but no evidence of TAC nephrotoxicity. The last biopsy after discontinuation of TAC demonstrated acute rejection of borderline grade. The s-Cr level at discharge was 5.0 mg/dL. The contra-lateral kidney was transplanted into a 31-year-old female and showed early functioning, with an s-Cr level at discharge of 1.8 mg/dL. Biopsy examination on POD 38 showed a recovery of tubular degeneration. The causes of delayed graft function and persistently high level of s-Cr in Case 1 remain unclear. Various factors, including donor-related factors, recipient-related factors, TAC nephrotoxicity, acute rejection, and urinary tract infection could all be associated with this condition.
authors.affiliation: Department of Urology, Nagasaki University School of Medicine, Sakamoto, Nagasaki City, Japan. nishiki@net.nagasaki-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Nishikido
authors.forename: M
authors.initials: M
authors.lastname: Noguchi
authors.forename: S
authors.initials: S
authors.lastname: Koga
authors.forename: H
authors.initials: H
authors.lastname: Kanetake
authors.forename: T
authors.initials: T
authors.lastname: Harada
authors.forename: T
authors.initials: T
authors.lastname: Taguchi
authors.forename: J
authors.initials: J
authors.lastname: Watanabe
authors.forename: F
authors.initials: F
authors.lastname: Matsuya
authors.forename: M
authors.initials: M
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000473:pathology*; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020858:Tissue and Organ Harvesting; D014552:Urinary Tract Infections / Q000150:complications
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine