GALLOPAMIL REDUCES THE POSTTRANSPLANTATION ACUTE TUBULAR-NECROSIS IN KIDNEYS FROM AGED DONORS

Due to a shortage of suitable kidneys for transplantation there has be en an increase in the use of kidneys taken from old and marginal donor s, which has led to a high incidence of acute tubular necrosis. Severa l reports suggest that the administration of calcium channel blockers improves the initial function after renal transplantation. We conducte d a randomized, double-blind placebo-controlled trial to study the eff ect of the calcium channel blocker gallopamil on the incidence and cou rse of acute tubular necrosis following cadaveric renal transplantatio n. A trend developed showing a decrease in episodes of acute tubular n ecrosis in gallopamil versus placebo, and became statistically signifi cant when the outcome of kidneys from donors older than 50 years was a nalyzed separately [gallopamil 6/14 (42%) vs. placebo 10/11 (91%), P < 0.01 corrected chi(2)]. We conclude that pre-transplantation renal gr aft perfusion and post-transplantation recipient treatment with gallop amil reduces the incidence of post-transplantation acute tubular necro sis, particularly in kidney taken from older donors.