Variables during care of adult donors that can influence outcomes of kidney transplantation.
Publications that relate characteristics of donors to renal function of recipients are reviewed. Most publications report retrospective observations that relate outcomes to donor variables that cannot be altered during donor care. Factors that can be altered in adult donors in an effort to improve recipients' outcomes include urine output and creatinine level. Increasing urine output to more than 100 mL/h, at least during the hour before explantation, and returning the creatinine level to match its serum concentration when the patient was admitted can improve outcomes. Ways of accomplishing those goals during donor care are discussed, with emphasis on support of renal blood flow.
Powner
David J
DJ
Department of Neurosurgery, University of Texas Health Science Center at Houston, TX, USA.
D000328:Adult; D001803:Blood Transfusion; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003404:Creatinine / Q000378:metabolism; D004232:Diuretics / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use; D017053:Infection Control; D007668:Kidney / Q000187:drug effects / Q000502:physiology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008657:Metabolic Clearance Rate; D010952:Plasma Substitutes / Q000627:therapeutic use; D011300:Preoperative Care / Q000379:methods* / Q000592:standards; D012079:Renal Circulation; D012107:Research Design; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods; D016896:Treatment Outcome; D014563:Urodynamics
D002316:Cardiotonic Agents; D004232:Diuretics; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D003404:Creatinine; D004298:Dopamine