Study clarifies causes of acute renal transplant failure

Although inflammation in deceased donor kidneys represents an increased risk in acute transplant failures, there is no causal connection, Austrian researchers say.

Rainer Oberbauer, MD, and colleagues from the Medical University of Vienna, and Elisabethinen Hospital, Linz, Austria, studied a total of 306 organ donors and 455 transplant recipients at three transplantation centers. Half of the donors were given steroids (cortisone, 1 gram) on a blinded basis, and the other half received placebo.

The team, which reported its findings in the Annals of Internal Medicine (2010; 153:222-30), found that administering steroids suppresses inflammation in the donor organ but has no effect on acute renal failure. With both test groups, the probability of organ failure was around 25%, and at 4 to 5 days, there was no major difference in the duration until acute renal failure occurred.

"As well as inflammation, there must therefore be other causes of the immediate acute transplant failure which are not influenced by steroids," Dr. Oberbauer said.