Abstract • Of 431 cadaver kidneys available for transplantation, 75 were discarded after a period of pulsatile perfusion. Kidneys were discarded because of poor flow, multiple arteries with segmental obstruction, prolonged warm ischemia time, perfusion pump malfunction, and lack of donor cells for crossmatching, among other reasons. Certain selected variables common to transplanted kidneys and kidneys discarded have been analyzed. The most significant finding was that 70% of transplanted kidneys came from donors who had received pretreatment with either phenoxybenzamine hydrochloride, methylprednisolone sodium succinate, or phentolamine mesylate. Only 33.3% of kidneys discarded were taken from donors who had received such pretreatment (P<.01). Attention is focused on the need for careful consideration of the technical aspects of donor nephrectomy as well as the need for donor pretreatment, in order to decrease the number of discarded kidneys. (Arch Surg 111:1129-1130, 1976) References 1. Cho SI, DerHagopian RP, Krane RS, et al: Regional organ preservation program in the New England area . Surgery 75:528-534, 1974. 2. Belzer FO, Ashby BS, Dunphy JE: 24-hour and 72-hour preservation of canine kidneys . Lancet 2:536-539, 1967.Crossref 3. Belzer RO, Schweizer RT, Hoffman R, et al: Preservation and transplantation of human cadaver kidneys . Transplantation 14:363-367, 1972.Crossref 4. Moore TC, English TS, Conovaloff BS, et al: Factors involved in discarding cadaveric kidneys preserved by machine perfusion . Surg Gynecol Obstet 138:545-548, 1974. 5. Kane JF, Edwards EC: Renal vascular shutdown during perfusion of the isolated kidney . Br J Urol 38:664-672, 1966.Crossref 6. Miller HC, Alexander JW: Protective effect of methylprednisolone against ischemic injury to the kidney . Transplantation 16:57-60, 1973.Crossref 7. Miller HC, Alexander JW, Smith EJ, et al: Salutary effect of phentolamine (Regitine) on renal vasoconstriction in donor kidneys . Transplantation 17:201-210, 1974.Crossref 8. Belzer FO, Reed TW, Pryor JP, et al: Cause of renal injury in kidneys obtained from cadaver donors . Surg Gynecol Obstet 130:467-477, 1970.
Archives of Surgery – American Medical Association
Published: Oct 1, 1976