Donor hydration level influence on kidney graft function in early posttranslant period

Poor kidney graft function in kidney transplantation (KT) is often associated with worse long-term outcomes. The aim of this study was to identify impact of deceased donor (DD) hydration level on kidney graft function in early period after kidney transplantation (KT). This retrospective study includes all consecutive deceased donor kidney transplantation cases performed in a single transplantation centre during the period from 01.01.2011 till 31.12.2012 (n=147). Exclusion criteria: DD age > 55 years old, moderate or severe hypertension in DD anamnesis; recipients and donors younger than 18 years; recipients with 3rd and 4th KT; recipients PRA>10%; abnormal graft vascular or ureteral anatomy; induction immunosuppression by ATG or maintenance immunosuppression different from standard triple immunosuppression (tacrolimus, mycophenolate mofetil, steroids); surgical complications in early post-transplant period. After selection study included 80 kidney transplantation cases from 58 deceased donors. We analysed association of DD Haemoglobin (HGB) concentration and donor Haematocrit (HCT) with the following kidney graft function indicators: serum creatinine (s-Crea) concentration before transplantation and at 1st, 2nd, 3rd, 4th, 5th, 7th, 14th days after KT; s-Crea reduction ratio at 1st, 7th and 14th postransplant days; 24 hours fluid intake and diuresis volumes during 14 days after KT; incidence of delayed graft function (DGF, defined as need for hemodialysis during the first week after KT). DD HCT index before organ explantation within the range 25 to 36% and HGB concentration 80 to 120 g/L were associated with better kidney graft function and reduced DGF development rate (p<0.05 for all). Adequate donor hydration was associated with better kidney graft function, showing the need to ensure adequate hydration level in potential deceased kidney donors.