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Results of Kidney Transplant From Donors With Sepsis-Induced Acute Kidney Injury

Introduction Acute kidney injury (AKI) is a syndrome comprising multiple clinical conditions and the most common cause of AKI in critically ill patients is sepsis. The pathophysiology of sepsis-induced AKI is complex and multifactorial. The functional consequences during sepsis-induced AKI are dramatic, the histological changes are moderate and do not entirely explain the clinical status. Resolved septicemia is a relative contraindication to organ procurement. Methods Two young patients with brain injury were hospitalized on ICU and both developed sepsis due to aspiration pneumonia. These patients were around 30 years old and had no medical history before this hospitalization. The antibiotic treatment was in accordance with microbiological results of BAL and blood cultures. Both patients developed sepsis-induced AKI and were treated with CRRT. Bood microbiological test were negative in third day of antibiotic therapy. After diagnosis of brain death they were classified as marginal donors with diagnosis of resolved septicemia. We decided to transplant the organs after the optimistic histological results of biopsy taken from retrieved kidneys. Results The histological exam showed focal and mild acute tubular necrosis without inflammation and four kidneys were transplant. None of the organ recipient developed any inflammatory complications and their transplant kidney function one year after transplant procedure remains stabile. Conclusion The pathomechanism of sepsis related AKI is complex and patient with sepsis related AKI may become a kidney donor in particular conditions. References: 1. Zarbock A, Gomez H, Kellum JA. Sepsis-induced acute kidney injury revisited: pathophysiology, prevention and future therapies. Curr Opin Crit Care 2014, 20:588-595. 2. Ronco C, Kellum J, Bellomo R, House AA. Potential Interventions in Sepsis-Related Acute Kidney Injury. Clin J Am Soc Nephro 3: 531-544, 2008.