title: Red Kidney: Kidney Transplant From a Deceased Donor Who Received Massive Blood Transfusion During Cardiopulmonary Bypass.
abstract: Here, we present a case of a deceased-donor kidney transplant. The brain-dead donor had received a massive blood transfusion during cardiopulmonary bypass, which lead to hemolysis, hemoglobinuria, acute kidney injury, and renal replacement therapy. The kidney appeared red after in situ flush. Postoperatively, the recipient developed delayed graft function. Protocol biopsy during the postoperative period revealed the widespread deposition of heme pigment in the renal tubules. Massive blood transfusion and cardiopulmonary bypass surgery are associated with hemolysis and heme pigment deposition in the renal tubules, which subsequently lead to acute kidney injury. Kidneys from such donors appear red and, while this does not preclude transplant, are likely to develop delayed graft function.
authors.affiliation: From the Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds and United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Bell
authors.forename: Faisal
authors.initials: F
authors.lastname: Hanif
authors.forename: Padmini
authors.initials: P
authors.lastname: Prasad
authors.forename: Niaz
authors.initials: N
authors.lastname: Ahmad
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D000328:Adult; D001706:Biopsy; D001926:Brain Death; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D051799:Delayed Graft Function / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D046148:Donor Selection; D006418:Heme / Q000378:metabolism*; D006456:Hemoglobinuria / Q000209:etiology; D006461:Hemolysis; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D006435:Renal Dialysis; D014019:Tissue Donors; D065227:Transfusion Reaction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006418:Heme