Influence of Acute Tubular Necrosis on First Cadaver Kidney Transplant Function

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Abstract
Prolonged cold storage following intracellular electrolyte flushing increases the probability of significant acute tubular necrosis after cadaver kidney transplantation. The renal function of primary cadaver kidney grafts was compared in 68 recipients who required dialysis and 92 who did not require dialysis during the 1st wk after transplantation. All kidneys were retrieved from beating-heart cadaver donors, flushed with ice-cold intracellular electrolyte solution and cold-stored until transplantation. Recipients requiring dialysis during the 1st week after transplantation received kidneys with a significantly longer cold storage time (27.4 .+-. 10.2 vs. 23.2 .+-. 7.6 h) and had significantly higher 1 mo. serum creatinine nadirs (2.1 .+-. 1.3 vs. 1.5 .+-. 0.6 mg/dl). Actuarial kidney graft survivals and serum creatinine levels 1-5 yr after grafting were not significantly different. Acute tubular necrosis following primary cadaver kidney transplantation does not adversely affect long-term function of kidney grafts flushed with intracellular electrolyte solution and cold-stored until transplantation.