투석이 필요한 상태의 뇌사 공여자로부터 신장이식 결과: 27예 (Kidney Transplantation from the Deceased Donor Who Need Continuous Renal Replace Therapy)

서지정보

· 발행기관 : 대한이식학회
· 수록지 정보 : Clinical Transplantation and Research / 29권 / 4호 / 233 ~ 237페이지
· 저자명 : 이주연, 김영훈, 권현욱, 최지윤, 신성, 정주희, 홍정자, 한덕종

초록

Background: Brain death donors may require continuous renal replacement therapy (CRRT) in severe acute renal failure (ARF) during management. To maximize donor organ usage we performed renal transplantation from deceased donors requiring CTTR with informed consent. This single-center study reviewed the clinical outcomes of kidney transplant recipients from extreme marginal donors requiring CRRT.
Methods: Medical records of all patients using a graft from extreme marginal donors who underwent CRRT in Asan Medical Center between June 2007 and September 2014 were reviewed retrospectively.
Results: Between June 2007 and September 2014, 27 kidneys were transplanted from 19 CRRT donors. Mean donor age was 35.1 years (range; 16~56), male donors were 14 (74%). The causes of brain death included head trauma in 6, hypoxia in 5, stroke in 4, and others in 4. The main causes of CRRT were anuria in 14, electrolyte imbalance or acidosis in 5, and mean duration of donor CRRT was 3.6 days (range; 1~11). Delayed graft function (DGF) developed in 24 (88.9%), but all recovered renal function; they can be free from dialysis 11 days after transplantation. Mean serum creatinine level at 1 month, 1 year, and 5 years was 1.85, 1.26, and 1.31 mg/dL, respectively.
Conclusions: Five-year follow-up data showed that renal transplantation from severe ARF donor has an excellent outcome.
Although CRRT donor kidney transplants have a higher rate of DGF, the presence of DGF, unlike other donation after brain death donor kidney transplants, does not portend a worse prognosis.

영어초록

Background: Brain death donors may require continuous renal replacement therapy (CRRT) in severe acute renal failure (ARF) during management. To maximize donor organ usage we performed renal transplantation from deceased donors requiring CTTR with informed consent. This single-center study reviewed the clinical outcomes of kidney transplant recipients from extreme marginal donors requiring CRRT.
Methods: Medical records of all patients using a graft from extreme marginal donors who underwent CRRT in Asan Medical Center between June 2007 and September 2014 were reviewed retrospectively.
Results: Between June 2007 and September 2014, 27 kidneys were transplanted from 19 CRRT donors. Mean donor age was 35.1 years (range; 16~56), male donors were 14 (74%). The causes of brain death included head trauma in 6, hypoxia in 5, stroke in 4, and others in 4. The main causes of CRRT were anuria in 14, electrolyte imbalance or acidosis in 5, and mean duration of donor CRRT was 3.6 days (range; 1~11). Delayed graft function (DGF) developed in 24 (88.9%), but all recovered renal function; they can be free from dialysis 11 days after transplantation. Mean serum creatinine level at 1 month, 1 year, and 5 years was 1.85, 1.26, and 1.31 mg/dL, respectively.
Conclusions: Five-year follow-up data showed that renal transplantation from severe ARF donor has an excellent outcome.
Although CRRT donor kidney transplants have a higher rate of DGF, the presence of DGF, unlike other donation after brain death donor kidney transplants, does not portend a worse prognosis.

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