Rhabdomyolysis with acute kidney injury in deceased donors is not a contraindication for kidney donation

Deceased patients with acute kidney injury (AKI) from rhabdomyolysis can be considered as potential kidney donors. We performed a retrospective chart review from January 2005 to January 2011 of three donors with AKI from rhabdomyolysis and the four recipients of the donated kidneys. Three donors had AKI from rhabdomyolysis as evidenced by elevated serum creatinine levels, myoglobinuria, and plasma creatinine kinase levels greater than five times the upper limit of normal. All grafts were maintained on pulsatile machine perfusion (MP) prior to transplantation. In one of the patients, serial venous perfusate myoglobin levels were measured from the donor kidney while on MP. Three of the four recipients had delayed graft function, but all had normalized creatinine function after 1 month. One recipient had a creatinine of 1.2 after 79 months, the longest documented follow-up of this kind. Although we measured venous perfusate myoglobin levels from one of the grafts, we found the levels to decrease with increasing time spent on MP. Potential donors with AKI secondary to rhabdomyolysis should not be restricted from the donor pool. MP may play a role in minimizing the effects of AKI in these types of donors.