A Kidney with Type II Damage to be Transplanted into a Patient Undergoing Treatment with Antiplatelet and Anticoagulant Medications

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Abstract

Background

The number of cadaveric kidney transplants in our country as grown to nearly 300 cases per year, with the average waiting period for a healthy kidney being 16 years. In this report, we describe the graft survival time after transplantation of a cadaveric kidney that was first screened for damage.

Case Presentation

A 64-year-old man who had undergone dialysis for 17 years presented to our clinic to undergo kidney transplantation. He had undergone previous operations for aortic valve replacement and coronary artery bypass and had been using antiplatelet and anticoagulant drugs since 62 years of age. The kidney donor was a 34-year-old man who had died due to an acute subdural hematoma that developed after a fall. Despite attempts to administer first aid, the man was considered brain dead. The donor’s kidney was then inspected and was found to exhibit type II damage. Moreover, arteriography on the day of the donor’s hospital admission revealed leakage of contrast medium. The kidney capsule exhibited lacerations and damage to the renal parenchyma, but was transplanted without additional treatment using conventional techniques. There was an increase in ecchymoma around the kidney at post-operative day 4, but it was improved with conservative treatment. The transplanted kidney exhibited good function and the patient was discharged without complication.

Conclusions

To the best of our knowledge, the present case is the first report in our country involving the transplantation of a cadaveric kidney with renal parenchyma damage. Moreover, this case demonstrates the suitability of a kidney with type II damage to be transplanted into a patient undergoing treatment with antiplatelet and anticoagulant medications. There are many instances in which a type II-damaged kidney can be preserved using conventional techniques. Therefore, cadaveric kidneys that are screened based on a careful damage assessment represent a possible source for transplantation.

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