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Two cases of primary non-functioning kidney from the same donor

Two cases of primary non-functioning kidney from the same donor

Authors :
Fukuzo Matsuya
Shigehiko Koga
Takashi Taguchi
Mitsuru Noguchi
Hiroshi Kanetake
Mikio Hayashi
Yasushi Mochizuki
Arifa Nazneen
Takashi Harada
Masaharu Nishikido
Source :
Clinical Transplantation. 21:64-68
Publication Year :
2007
Publisher :
Wiley, 2007.

Abstract

We report two cases of primary non-functioning kidney from the same non-heart beating donor (NHBD). A 42-yr-old man received a renal transplant from a NHBD. The donor was a 38-yr-old male who died of neck spinal injury. The warm ischemic time was 61 min. One h after reperfusion, the graft became edematous and congested in the presence of normal and adequate vascular anastomosis and lack of renal vein thrombosis. The one-h biopsy specimen showed acute tubular necrosis and severe congestion with occasional platelet aggregates in glomerular capillaries. The graft was resected on post-transplantation day 6. Graftectomy specimen revealed renal cortical necrosis. The contralateral kidney of the same donor was transplanted into a 54-yr-old male. The one-h biopsy specimen showed tubular degeneration and neutrophil infiltration in peritubular capillaries, but no glomerular congestion or thrombus. The recipient died on post-transplantation day 4. Although the cause of death was unknown, necropsy of the renal graft showed renal cortical necrosis, similar to case 1. Ischemia/ reperfusion injury was considered the cause of non-functioning kidney in both cases, because of long warm ischemic time. The biopsy specimens at zero-h from both grafts showed focal tubular degeneration only without distinct necrosis, indicating it is difficult to predict viability based on the pathological findings at zero-h or one-h biopsies. There is a need for further understanding of clinical and histological patterns in order to define the criteria of viability of kidney transplant.

Details

ISSN :
13990012 and 09020063
Volume :
21
Database :
OpenAIRE
Journal :
Clinical Transplantation
Accession number :
edsair.doi...........8b160b37357c466796294f34d7781156
Full Text :
https://doi.org/10.1111/j.1399-0012.2007.00722.x