Impact of kidney donor hemostasis on risk of complications after transplantation – preliminary outcomes
Iza Iwan-Ziętek, Zbigniew Ziętek, Tadeusz Sulikowski, Andrzej Ciechanowicz, Marek Ostrowski, Danuta Rość, Marek Kamiński
Independent Laboratory of Aesthetic Dermatology, Pomeranian Medical University in Szczecin, Szczecin, Poland
Med Sci Monit 2013; 19:1102-1108
This study analyzes the influence the of kidney donor hemostasis on the risk of complications in the kidney recipient after transplantation.
Material and Methods: We enrolled 38 deceased kidney donors, of whom14 donors died from a physical injury and the others died from ischemic or bleeding central nervous system stroke. The donors were categorized into 2 subgroups. If the recipient’s postoperative period proceeded smoothly, the kidney donor was assigned to the uncomplicated donors (UD) group. If the recipient’s postoperative period was complicated, the donor was assigned to the complicated (CD) Group. The CD group of consisted of 9 donors who died from strokes or bleedings and 2 who died from physical injury. We examined the antithrombin (AT) protein C (PC), complexes of thrombin/antithrombin (TAT), fragments F1+2 of prothrombin (F1+2), plasminogen (Pl), complexes of plasmin/antiplasmin (PAP), and D-dimers (D-d).
Results: In the CD group had decreased activity of AT, PC, and Pl and increased activity of F1+2, TAT, and D-d. The UD group had a higher level of PAP. The CD group had evidence of intensive blood coagulation, but the UD group had evidence of fibrinolysis. Fisher’s exact test revealed an increased risk in recipients who received a kidney from the CD group.
Conclusions: The hemostasis of the kidney donors had a correlation with the occurrence of some complications in the kidney recipients, especially complications connected with activation of blood coagulation. It seems that the activation of fibrinolysis could be positive prognostic factor, but this requires further investigations.
Keywords: Cadaver, Antithrombin Proteins - metabolism, Hemostasis - physiology, Kidney Transplantation - adverse effects, Plasminogen - metabolism, Poland, Postoperative Complications - etiology, Protein C - metabolism, Prothrombin - metabolism, Renal Insufficiency - surgery, Statistics, Nonparametric, Tissue Donors