title: The effect of cause of cadaveric kidney donors death on fibrinolysis and blood coagulation processes.
abstract: BACKGROUND
  Organ donors can be generally divided into two groups according to the cause of their death. The first group is composed of those who died because of physical injuries, especially road traffic injury, and the second group, those who died from central nervous system (CNS) stroke or bleeding. The aim of our work was to examine hemostatic processes among kidney donors.
  
  
  METHODS
  The 38 deceased kidney donors (KD) included 11 women and 27 men of overall average age of 37±12 years. The donor group of according to the cause of death, included 14 injured donors (ID) (41%) and 24 noninjured donors (ND) donors (59%). The control group consisted of 25 healthy volunteers matched for sex and age. We determined the following concentrations: antithrombin (AT), thrombin/antithrombin complexes (TAT), and prothrombin F1+2 fragments. The fibrinolytic parameter concentrations were: plasminogen (PL), plasmin/antiplasmin complexes (PAP), and D-dimers.
  
  
  RESULTS
  Deceased kidney donors showed an increased plasma concentrations of TAT complexes (P<.000001) and prothrombin fragments F1+2 (P<.0000001); however, the protein C concentration was decreased (P<.000001). The antithrombin activity was similar to the control group. The concentrations of PAP complexes and d-dimers were higher (both P<.000001), but the level of PL lower among KD compared with controls (P<.0000001). The higher of TAT, PAP complexes, d-dimers, and F1+2 concentrations as well and as lower plasminogen and PC concentrations were evidence for increased activation of blood coagulation and fibrinolysis in cadaveric KD. However, analysis compairing ID versus ND donors revealed increased concentrations of PAP complexes (P<.05) and decreased amounts of TAT complexes (P<.01) among ID subgroup. The positive predictive value (PPV) and negative (NPV) for PAP complexes were 75% and 68% and for TAT, 71% and 57%, respectively. On the basis of these observations, we concluded that an intensive activation of fibrinolytic process occurs among the ID. In contrast, ND show intensive activation of blood coagulation.
authors: Department of Clinical Anatomy, Pomeranian Medical University, Szczecin, Poland.
authors: Z
authors: Z
authors: Ziętek
authors: I
authors: I
authors: Iwan-Ziętek
authors: T
authors: T
authors: Sulikowski
authors: J
authors: J
authors: Sieńko
authors: M
authors: M
authors: Zukowski
authors: M
authors: M
authors: Kaczmarczyk
authors: A
authors: A
authors: Ciechanowicz
authors: M
authors: M
authors: Ostrowski
authors: D
authors: D
authors: Rość
authors: M
authors: M
authors: Kamiński
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001777:Blood Coagulation; D002102:Cadaver; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D014947:Wounds and Injuries; D055815:Young Adult