Abstract

Background: Brain death is an important multi-factorial variable contributing to donor-specific kidney damage. Aim: Assessment of the influence of the cause of death of the multi-organ donors on the function of transplanted kidneys.
Material/Methods: 146 potential heart donors were included in the study. Brain stem death (BSD) protocol was used according to the standard criteria for the brain death diagnosis. Conventional supportive management consisted of: mechanical ventilation to normocapnia, re-warming, fluid and electrolyte replacement. Kidney recipients (a group of 232 patients) had kidney function monitored by serial serum creatinine level measurements on day 1, 2, 3, 7, 14, 30 and 90 post transplantation. The relationship between donor's cause of death (injury, bleeding and other) and serum creatinine levels in the postoperative period were analyzed. In statistical analysis the following tests were used: U Mann-Whitney, Chi correlation and regression and Fisher tests. A value of p<0.05 indicated statistical significance.
Results: In the group of recipients who received a kidney from donors that died due to reasons other than injury, significantly higher serum creatinine levels were observed up to the 14[sup]th[/sup] day post transplantation. In the group of recipients who received a kidney from donors who died due to bleeding, significantly higher serum creatinine levels were observed since the 30th day post transplantation.
Conclusions: 1. Cause of death other than injury or bleeding in multi-organ donors predicts worse kidney graft function in the first 14 days post transplantation. 2. Intracranial bleeding in multi-organ donors predicts worse kidney graft function in the first period after transplantation.

Keywords: Organ Procurement