title: Successful outcome of transplant of kidneys recovered from a brain-dead liver transplant recipient: case report.
abstract: Few reports describing the use of organs donated by transplant recipients have been published. In this case report, kidneys procured from a brain-dead liver recipient were transplanted successfully. A 21-year-old man was referred for liver transplant after an overdose of acetaminophen. The patient's kidney function was initially normal, with proper urine production and normal kidney laboratory parameters. On the third day after admission, the patient's kidney laboratory parameters became elevated and hepatic encephalopathy requiring mechanical ventilation developed. An orthotopic liver transplant was performed the next day. The patient did not recover consciousness, and brain death was diagnosed on the third day after the liver transplant surgery. The maximum serum concentration of creatinine was 5.8 mg/dL (513 μmol/L) before kidney recovery, and urine production was normal. The kidneys were recovered with organ-perfusion support and were preserved by using machine perfusion. The kidneys were transplanted into 2 male recipients. Twelve months after transplant, the recipients remained in good health with satisfactory kidney function. This case demonstrates that transplanting kidneys recovered from liver transplant recipients is possible and beneficial, thus expanding the pool of potential donors.
authors.affiliation: The Medical University of Warsaw, Poland. pdomagal@mp.pl
authors.forename: Piotr
authors.initials: P
authors.lastname: Domagała
authors.forename: Artur
authors.initials: A
authors.lastname: Kwiatkowski
authors.forename: Jakub
authors.initials: J
authors.lastname: Drozdowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Ostrowski
authors.forename: Michal
authors.initials: M
authors.lastname: Wszola
authors.forename: Piotr
authors.initials: P
authors.lastname: Diuwe
authors.forename: Magdalena
authors.initials: M
authors.lastname: Durlik
authors.forename: Leszek
authors.initials: L
authors.lastname: Paczek
authors.forename: Andrzej
authors.initials: A
authors.lastname: Chmura
mesh_terms: D000082:Acetaminophen / Q000506:poisoning; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000506:poisoning; D001926:Brain Death; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen