Influence of specific thoracic donor therapy on kidney donation and long-term kidney graft survival.
OBJECTIVE
To analyze the impact of a specific thoracic donor-treatment protocol (including restrictive fluid balance) on kidney donation and on kidney graft survival.


METHODS
A cohort study. Lung Donors and kidney recipients from 2003 to 2008 were the pre-protocol cohort, and those from 2009 to 2013 were the protocol cohort. The main outcome variables were graft survival and rate of kidney donation.


RESULTS
Kidney donation rates were similar in both periods (86.2 vs. 86.2 %; p > 0.05). Both donors and kidney recipients were older and with more comorbidities in the protocol group and this is the reason there were more cases of delayed graft function (differences not statistically significant) and with higher sequential creatinine levels of kidney recipients during the protocol period. However, graft survival was similar in both groups. The probability of graft survival 5 years after transplantation was 0.75 (95 % confidence interval 0.65-0.85) in the pre-protocol cohort and 0.81 (0.70-0.92) in the protocol cohort.


CONCLUSIONS
Specific treatment for multi-organ donors including restrictive fluid balance does not affect kidney donation or kidney graft loss, and has no impact on long-term viability. Hemodynamics must be closely monitored by medical personnel with specific training.
Department of Critical Care Medicine, University Hospital Marqués de Valdecilla-IDIVAL, Avda Valdecilla, s/n, 39008, Santander, Spain. gelesballesteros@yahoo.es.|Transplant Coordination Unit, University Hospital Marqués de Valdecilla-IDIVAL, Avda Valdecilla, s/n, 39008, Santander, Spain. gelesballesteros@yahoo.es.
María A
MA
Ballesteros
Department of Critical Care Medicine, University Hospital Marqués de Valdecilla-IDIVAL, Avda Valdecilla, s/n, 39008, Santander, Spain.
Jorge
J
Duerto Álvarez
Department of Nephrology, University Hospital Marqués de Valdecilla-IDIVAL, Avda Valdecilla, s/n, 39008, Santander, Spain.
Luis
L
Martín-Penagos
Department of Nephrology, University Hospital Marqués de Valdecilla-IDIVAL, Avda Valdecilla, s/n, 39008, Santander, Spain.
Emilio
E
Rodrigo
Department of Nephrology, University Hospital Marqués de Valdecilla-IDIVAL, Avda Valdecilla, s/n, 39008, Santander, Spain.
Manuel
M
Arias
Department of Critical Care Medicine, University Hospital Marqués de Valdecilla-IDIVAL, Avda Valdecilla, s/n, 39008, Santander, Spain.|Transplant Coordination Unit, University Hospital Marqués de Valdecilla-IDIVAL, Avda Valdecilla, s/n, 39008, Santander, Spain.
Eduardo
E
Miñambres
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
Donation after brain death; Kidney donation; Kidney transplantation; Long-term kidney transplantation; Specific treatment donor