Renal transplantation with kidneys from donors who died from poisoning by drugs or toxins

There are few published data on the results of kidney transplants from dono rs who died from poisoning by drugs or toxins. Of 5,053 donors registered i n Spain from 1993 to 1997, 41 (0.8%) died from acute poisoning. A total of 77 kidney transplants were performed and 50 (70.4%) recipients were followe d. The toxic agents were: CO (15), methanol (1,5) tricyclic antidepressants (5), benzodiazepines (2), butane gas (2) Ecstasy (2) tyoridacine (1), orga nophosphates (1) alcohol (2), hydracidas (1), cyanide (2), cocaine (2). Two patients died after 6 months from causes unrelated to the toxin: one fr om sepsis, in whom the kidney lost function early from acute rejection (CO) , the other from lymphoma (Ecstasy). Patient survival after one year was 95 .2%, similar to, that reported by National Registry of the Spanish Society of Nephrology (95%) and UNOS (94.7%). There were 7 (14%) cases of early non -functioning grafts: 4 CO lacute rejection (1), hypogastric artery obstruct ion (7), venous thrombosis (I), kidney rupture three days after transplanta tion ill; 1 methanol (acute rejection), 1 butane gas (acute rejection) and 1 benzodiazepines (acute tubular necrosis and arteriosclerosis). Graft surv ival after one month was 86%, lower than that reported by UNOS after 3 mont hs (91.2%). From these data we can state that there is no absolute contrain dication to using kidneys from donors who, died from poisoning by drugs or toxins. The higher incidence of early graft non-function, mostly in recipie nts whose grafts cam from donors poisoned with CO does not appear to be rel ated to the toxin.