Department of Urology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Int Urol Nephrol. 2012 Aug;44(4):1107-11. doi: 10.1007/s11255-012-0185-1. Epub 2012 May 3.
Deceased patients with acute kidney injury (AKI) from rhabdomyolysis can be considered as potential kidney donors.
We performed a retrospective chart review from January 2005 to January 2011 of three donors with AKI from rhabdomyolysis and the four recipients of the donated kidneys. Three donors had AKI from rhabdomyolysis as evidenced by elevated serum creatinine levels, myoglobinuria, and plasma creatinine kinase levels greater than five times the upper limit of normal. All grafts were maintained on pulsatile machine perfusion (MP) prior to transplantation. In one of the patients, serial venous perfusate myoglobin levels were measured from the donor kidney while on MP.
Three of the four recipients had delayed graft function, but all had normalized creatinine function after 1 month. One recipient had a creatinine of 1.2 after 79 months, the longest documented follow-up of this kind. Although we measured venous perfusate myoglobin levels from one of the grafts, we found the levels to decrease with increasing time spent on MP.
Potential donors with AKI secondary to rhabdomyolysis should not be restricted from the donor pool. MP may play a role in minimizing the effects of AKI in these types of donors.
横纹肌溶解导致急性肾损伤（AKI）的已故患者可被视为潜在的肾脏供体。
我们对 2005 年 1 月至 2011 年 1 月的 3 例 AKI 横纹肌溶解供体和 4 例接受捐赠肾脏的受体进行了回顾性图表审查。3 例供体的 AKI 横纹肌溶解表现为血清肌酐水平升高、肌红蛋白尿和血浆肌酸激酶水平高于正常上限的 5 倍。所有移植物在移植前均采用搏动式机器灌注（MP）进行维持。在其中 1 例患者中，在 MP 期间从供体肾脏测量了连续的静脉灌流肌红蛋白水平。
4 例受者中有 3 例出现移植肾功能延迟恢复，但所有受者在 1 个月后肌酐功能均恢复正常。1 例受者在 79 个月后肌酐为 1.2，这是此类研究中最长的随访记录。尽管我们从 1 个移植物中测量了静脉灌流肌红蛋白水平，但发现水平随着 MP 时间的延长而降低。
不应将继发于横纹肌溶解的 AKI 的潜在供体排除在供体库之外。MP 可能在减轻此类供体 AKI 方面发挥作用。
