ADVERSE EFFECT OF DONOR VASOPRESSOR SUPPORT ON IMMEDIATE AND ONE-YEARKIDNEY ALLOGRAFT FUNCTION

Background. This purpose of this study was to determine if there was a significant difference between the rates of acute tubular necrosis (A TN) and long-term graft survival in renal allografts procured from don ors requiring inotropic support (DRIS) and those from donors not requi ring inotropic support. Methods. Eighty-two consecutive cadaveric rena l transplant patients were prospectively followed in our local procure ment area, the Delaware Valley Transplant Program. Forty-eight patient s received organs from DRIS (> 10 mcg/kg per minute of dopamine, dobut amine, epinephrine, and norepinephrine alone or in combination), and 3 4 did not. Results. Allografts from the nonDRIS group had an immediate function rate of 82.4% and a 1-year function rate of 91.2%. In compar ison, the DRIS grafts had an immediate function rate of 58.3% and a 1- year function rate of 72.9%. These differences were statistically sign ificant. The mean serum creatinine in the non-DRIS group was 1.46 +/- 0.58 mg/dl, whereas in the DRIS cohort it was 1.89 +/- 0.93 mg/dl. Con clusions. Kidneys transplanted from DRIS had significantly (1) poorer immediate function, (2) worse 1-year survival rates, and (3) higher se rum creatinine at 1 year. We conclude that recipients receiving organs from donors requiring inotropic support are at a higher risk of devel oping ATN after surgery and experience reduced 1-year function.