CAN ORGAN DONOR DATA PROVIDE FACTORS INDI CATING THE FUNCTIONAL QUALITY OF KIDNEY-TRANSPLANT

The aim of this study is to find brain dead organ donor parameters abl e to predict the functional value of a kidney graft after transplantat ion. It is a retrospective, multicenter study, set in the east of Fran ce (Besancon, Nancy, Reims, Strasbourg). All donors harvested over an 18 month period (n = 169), and kidney grafts transplanted in a recipie nt in the same region (n = 298) are studied. Recipients from another r egion receving a kidney graft as well as kidney grafts transplanted in other regions are not studied. Parameters studied in the donor are: a ge, sex, etiology of brain death, vascular disease, hemodynamic stabil ity, use of epinephrine, diuresis, creatinine level, graft preservatio n solution. Parameters studied in the recipient are: age, sex, first t ransplantation or not, cold ischemia duration, warm ischemia duration, early post-transplantation diuresis and creatinine level evolution, d ialysis requirement, immunosuppression, creatinine level at 1, 6 and 1 2 month. During the early post transplantation period, 264 recipients recovered diuresis, and the creatinine level felt in 246 cases. 31 pat ients required dialysis. 12 months after transplantation, 128 patients had a normal graft function (creatinine level <15 mg/l). No parameter in the donor was found able to predict kidney graft function after tr ansplantation. In fact, it is the amount of several risk factors due t o donor data, organ retrieval and preservation, and kidney transplanta tion which is responsible for the early graft function. This points ou t the important of being very careful when there is already a risk fac tor due to a old age or vascular disease. Old age seems to be responsi ble for a bad evolution of the kidney graft, but this needs to be clar ified by means of a more detailed study, possibly allowing an increase improvement in the number of organs suitable for transplantation with out increasing the risk of renal dysfunction in the recipient.