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Effect of disseminated intravascular coagulation on donation after citizens' death donor kidneys
Lu Xu1, Wei Yin1, Guanghui Li1
1Organ Transplantation Center of the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Insights
Disseminated intravascular coagulation (DIC) in deceased organ donors increases kidney rejection and glomerular microthrombus formation. This impacts donor kidney viability and transplant success rates.
Area of Science:
- Nephrology
- Transplantation Immunology
- Pathology
Background:
- Disseminated intravascular coagulation (DIC) is a critical condition affecting organ donation.
- Understanding its impact on donor kidneys is vital for improving transplant outcomes.
Purpose of the Study:
- To investigate the effect of DIC on donor kidney quality in donation after citizens' death (DCD) donors.
- To assess the correlation between DIC and kidney rejection and microthrombus formation.
Main Methods:
- Retrospective analysis of 159 DCD donors' clinical and laboratory data.
- DIC diagnosis using the Chinese DIC scoring system (CDSS).
- Comparison of kidney rejection and glomerular microthrombus rates between DIC (+) and DIC (-) groups.
Main Results:
- The donor rejection rate was significantly higher in the DIC (+) group compared to the DIC (-) group (P<0.05).
- Glomerular microthrombus formation was significantly more prevalent in DIC (+) donors (P<0.05).
- Five cases of severe glomerular microthrombus led to donor kidney discard.
Conclusions:
- Donor-induced DIC is a significant risk factor for renal glomerular microthrombus formation.
- DIC in DCD donors increases the likelihood of donor kidney rejection, impacting organ utilization.
Background:
To investigate the effect of disseminated intravascular coagulation (DIC) on donor kidney in donation after citizens' death (DCD) donors.
Methods:
The clinical and laboratory data of 159 DCD donors obtained by our center in 2018 were retrospectively analyzed. The DIC diagnosis was performed according to the Chinese DIC scoring system (CDSS). The donors were divided into two groups: DIC (+) and DIC (-). The difference between kidney rejection rate and zero puncture glomerular microthrombus formation rate were compared.
Results:
Among the 159 DCD donors, 11 were discarded (accounting for 6.91%). The reasons for the discarded cases included 5 cases (3.14%) for moderate and severe glomerular microthrombus formation in the renal zero puncture pathology; 2 cases (1.26%) for glomerular sclerosis ratio over 50%; 2 cases (1.26%) for long-term low blood pressure before pregnancy and significantly increased serum creatinine level and no urine; 1 case (0.73%) for kidney stones and stagnant water; 1 case (0.63%) for malignant tumor. The donor rejection rate of the DIC (+) group was higher than that of the DIC (-) group, and the difference was statistically significant (P<0.05). Among all donors, 10 cases (6.29%) were found to have glomerular microthrombus at zero puncture, and the microthrombotic rate in the DIC (+) group was significantly higher than that in the DIC (-) group (P<0.05). Of the 10 microthrombotic donors, 5 donors with severe glomerular microthrombus were discarded.
Conclusions:
Donor-induced DIC can easily cause renal glomerular microthrombus formation, and the donor kidney rejection rate has increased.
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