Wang CJ, Shafique S, McCullagh J, Diederich DA, Winklhofer FT, Wetmore JB. Implications of donor disseminated intravascular coagulation on kidney allograft recipients.
Clin J Am Soc Nephrol 2011;
6:1160-7. [PMID:
21372214 PMCID:
PMC3087784 DOI:
10.2215/cjn.07280810]
[Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 12/16/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES
Disseminated intravascular coagulation (DIC) is common in deceased kidney donors and is considered a relative contraindication to donation. The significance of donor DIC on recipient kidney function is poorly understood. Additionally, the significance of thrombocytopenia in recipients of kidneys from DIC-positive donors is understudied.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
In a retrospective cohort of 162 kidney transplants, the presence of DIC in donors, the occurrence of thrombocytopenia in recipients, and risk factors for delayed or slow graft function (DGF/SGF) were assessed. The effects of DIC donor status on DGF/SGF in the study sample as a whole, and of thrombocytopenia on DGF/SGF in recipients of DIC-positive kidneys specifically, were examined using multiple logistic regression.
RESULTS
DIC donor status was not associated with occurrence of DGF/SGF, but thrombocytopenia was significantly associated with DIC-positive donor status (P=0.008). Thrombocytopenia was independently associated with DGF/SGF only in the recipients of DIC-positive kidneys (P=0.005). Patient and graft survival at 1 year were not affected by donor DIC status or by thrombocytopenia status.
CONCLUSIONS
Donor DIC was not associated with short-term suboptimal graft function, defined as DGF/SGF, nor with long-term patient or graft survival. However, thrombocytopenia appears to portend DGF/SGF in recipients of DIC-positive kidneys and may be a clinical sign on which the basis of therapeutic decisions could be undertaken.
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