[Kidney donor with severe disseminated intravascular coagulation: transplantation however successful].
A 41-year-old male, with no previous medical history, was admitted to our intensive care unit with severe isolated neurotrauma and a Glasgow Coma Scale of E1-M1-V1, mid-dilated unreactive pupils and severe abnormalities on the brain CT-scan. A severe syndrome of disseminated intravascular coagulation (DIC) and non-oliguric renal insufficiency developed. Following clinical and neurophysiological examination the patient was declared brain-dead, and the family gave permission for organ donation. The left kidney was transplanted and functioned well immediately. However, in view of the DIC and renal function disorders the right kidney was not considered usable for transplantation elsewhere. Pathological examination revealed many fibrin thrombi in the glomerular capillaries and acute tubular necrosis. This case supports the view that thrombotic microangiopathy in kidneys of patients with DIS, even with renal function impairment, is not an a priori reason for excluding donation.
Maastricht Universitair Medisch Centrum, Afd. Intensive Care, Maastricht, The Netherlands. lkeeris@hotmail.com
Lodewijk M
LM
Keeris
Dennis C J J
DC
Bergmans
Frank M
FM
van der Sande
Tineke J
TJ
Wind
Robert Jan
RJ
van Suylen
Walther N K A
WN
van Mook
D058186:Acute Kidney Injury / Q000150:complications*; D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000150:complications*; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male