M Zukowski, R Bohatyrewicz, J Biernawska, K Kotïfs, Z Zietek
Ann Transplant 2009; 14(1): 69-70
Available online: 2009-05-21
Background: Following kidney transplantation septic complications are one
of the leading causes of therapeutic failure. Early diagnosis may protect the
recipient from severe consequences of sepsis. Aim: Determination of the
risk factors inï¬‚uencing the occurrence of septic complications in kidney
Material/Methods: 146 heart beating donors were included in the study.
Standard brain-stem death criteria were applied for the brain death diagnosis. Conventional supportive management consisted of: mechanical ventilation to normocapnia, re-warming, ï¬‚uid and electrolyte replacement. Hemodynamic data acquired by thermodilution method was completed prior to the organ procurement. Variables measured prior to organ procurement were: mean arterial pressure (MAP), central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP) and systemic vascular resistance index (SVRI). Recipients' data was gathered by the authors based on the medical documentation. A group of 232 kidney recipients was examined for the occurrence of septic complications, including: sepsis, pneumonia, peritonitis and graft infection. Statistical analysis was performed using U Mann- Whitney, Chi2, and Fisher tests. A value of p<0.05 indicated statistical significance.
Results: Kidney transplant from the donors with MAP <70 mmHg and SVRI
<1200 dyne - s/cm[sup]5[/sup] - m[sup]2[/sup] resulted in statistically significantly higher occurrence of septic complications in kidney recipients (p<0.05). Mortality in those groups was also significantly higher (p<0.01).
Conclusions: MAP <70 mmHg, SVRI <1200 dyne - s -/cm[sup]5[/sup] - m[sup]2[/sup]of organ donors predicted higher occurrence of septic complications in kidney transplant recipients including mortality.
Keywords: Organ Procurement