IMPACT OF VARIOUS DONOR RELATED FACTORS O N EARLY AND LATE RENAL-ALLOGRAFT FUNCTION

Various factors such as cause of brain death, duration of intensive ca re, single or multiple organ procurement, renal function, heart rate, mean arterial blood pressure, requirement of catecholamines and metabo lic derangement were investigated in 86 consecutive organ donors with respect to the possible influence on initial graft function in 86 kidn ey recipients. Donor conditioning and perioperative recipient manageme nt were standardized. Donors of kidneys with initial graft function (g roup I) showed a significantly higher incidence (80%) of brain death a s a consequence of an isolated cerebral incident than donors of kidney s without initial graft function (group II), whereas the incidence of polytrauma (including cerebral) was much higher in donors of group II kidneys (42,9%). The donor requirement of catecholamines was higher in group II donors and the frequency of multiple organ donors was also h igher in this group. Five-year graft survival was 80% for group I kidn eys but only 62% for group II kidneys. The other factors had no influe nce on initial graft function. These data demonstrate that multiple in juries and multiple organ procurement have a negative impact on the in itial function of the transplanted kidney, possibly due to prolonged i schemic insult.