ABSTRACT
The demand for kidney transplantation due to improved recipient outcomes has stimulated surgeons to expand the criteria for usable donors, but still the use of organs from deceased donors with terminal acute renal failure is uncommon. We report 2 kidney transplant recipients from a cadaveric donor who was not accepted by other centers because of acute renal failure. The donor, a 24-year-old man with an intracerebral hemorrhage, displayed a serum creatinine (SCr) value of 0.6 mg/dL on hospital admission, which increased to 7.3 mg/dL on the fourth hospital day. After the diagnosis of brain death and refusal of the kidneys by other regional centers, we decided to transplant the 2 kidneys. Recipient 1, a 31-year-old man on an 11-year dialysis program, discontinued hemodialysis after 7 days of delayed graft function. The SCr level decreased gradually and was stable at 1.08 mg/dL on postoperative day (POD) 45. The contralateral graft was transplanted into a 30-year-old man (recipient 2) undergoing dialysis treatment for 7 years. After 10 days of delayed graft function, the SCr decreased gradually with continued hemodialysis until POD 24. The SCr level has been stable at 1.34 mg/dL on POD 52. At the end of the third month the SCr levels in recipients 1 and 2 were 1.1 mg/dL and 1.4 mg/dL, respectively. In conclusion, one may safely expand the donor pool with kidneys from deceased donors with acute renal failure (ARF) with good short-term outcomes.
Subject(s)
Acute Kidney Injury/etiology , Donor Selection , Kidney Transplantation , Kidney Tubular Necrosis, Acute/etiology , Tissue Donors , Adult , Biomarkers/blood , Brain Death , Cadaver , Creatinine/blood , Delayed Graft Function/diagnosis , Delayed Graft Function/etiology , Delayed Graft Function/therapy , Humans , Kidney Transplantation/adverse effects , Male , Renal Dialysis , Time Factors , Treatment Outcome , Young AdultSubject(s)
Catheters, Indwelling/adverse effects , Catheters, Indwelling/microbiology , Device Removal , Peritoneal Dialysis , Peritonitis/microbiology , Salmonella Infections/etiology , Salmonella typhimurium , Aged , Anti-Infective Agents/therapeutic use , Ciprofloxacin/therapeutic use , Humans , Kidney Failure, Chronic/therapy , Male , Peritoneal Dialysis/instrumentation , Peritonitis/therapy , Salmonella Infections/drug therapy , Vancomycin/therapeutic useABSTRACT
Membranous nephropathy is the most common cause of adult-onset idiopathic nephrotic syndrome. Glomerular disease has been reported to occur in association with a wide variety of malignancies, particularly carcinomas and lymphomas. With the case reported here, we relate acute myeloid leukemia with membranous glomerulonephritis, depending on the previous literature reports about the association of malignancies and glomerulopathies.
