[Deceased Donor Kidney Transplantation from a Liver Transplantation Recipient]

Area of Science:

• Nephrology
• Transplantation Immunology
• Histopathology

Background:

• End-stage renal disease (ESRD) management often involves kidney transplantation.
• IgA nephropathy is a common cause of ESRD requiring renal replacement therapy.
• Deceased donor kidney transplantation presents unique challenges and considerations.

Observation:

• A 40-year-old male patient with ESRD secondary to IgA nephropathy underwent deceased donor kidney transplantation.
• The donor kidney exhibited moderate global glomerular sclerosis (22%) and interstitial fibrosis (40%) on intraoperative biopsy.
• The donor had a history of brain death following liver transplantation for non-viral liver cirrhosis.

Findings:

• The graft kidney showed histological signs of nephrosclerosis or calcineurin inhibitor nephrotoxicity.
• Post-transplantation, the patient required temporary hemodialysis before graft function was established.
• The kidney graft demonstrated successful function with stable serum creatinine levels (approx. 2.4 mg/dL) at six months post-transplant.

Implications:

• This case highlights the potential for successful kidney allograft function despite pre-existing histological abnormalities in the donor kidney.
• It underscores the importance of careful patient selection and post-transplant management in deceased donor kidney transplantation.
• The findings suggest that significant histological damage in a donor kidney may not preclude a favorable long-term outcome.