Single center experience transplanting kidneys from deceased donors with terminal acute renal failure

BackgroundTransplantation of kidneys from deceased donors with terminal acute renal failure (ARF) is uncommon.MethodsWe reviewed retrospectively our single-center experience with transplantation of ARF donor kidneys.ResultsFrom January 2007 through September 2008, we transplanted 25 kidneys from 17 ARF donors; 22 kidneys were from standard criteria donors. Mean donor age was 34 years. Mean admission and terminal donor serum creatinine values were 1.3 mg/dL and 3.1 mg/dL. All but 2 kidneys were placed on pump preservation; mean cold ischemia time was 27 hours. The recipient group had a mean age of 49 years and a mean waiting time of 24 months. Patient and graft survival rates were 100% and 92%, respectively, with a mean follow-up of 12 months. Delayed graft function occurred in 8 patients (32%), mean initial duration of stay was 6 days, 3 patients (12%) required re-operation, 3 patients (12%) had acute rejection, and 8 patients (32%) developed infections. Mean 1- and 12-month recipient serum creatinine and glomerular filtration rate values were 1.9 mg/dl (45 mL/min) and 1.5 mg/dl (50 mL/min), respectively.ConclusionKidneys from deceased donors with terminal ARF have excellent short-term outcomes and represent another potential method to safely expand the donor pool.