Introduction: One of the possibilities is the utilize of personalized medicine, a method based on quantifiable and theoretical agents that assign the worldwide immunological hazard of refusal for each patient.
Kidney transplantation is the best treatment for end-stage renal disease patients. Although the shortage of kidneys for transplantation has been addressed by expanding the criteria, transplantation teams in Iran don’t have great tendency to implant marginal organs from brain death donors specially the ones with high creatinine before harvesting. The aim of this study was to evaluate the impact of brain dead donor serum creatinine (Cr) level on outcome of transplanted kidneys. Methods: In this retrospective study, the records of ۴۶ brain-dead donors of Masih Daneshvari organ procurement unit of Tehran, Iran were assessed. The medical file of donated ۵۸ recipients was available. Donor demographic data (age, sex), brain death cause and the Cr level after transferring to OPU ICU were recorded. The Cr level was categorized based on ≥۱.۴ mg/dl with origin of prerenal azotemia or lower. The urine output of transplanted patients in the first ۲۴ hours post-transplant, serum Cr level at discharge from hospital and dialysis during first month after transplantation were compared between two groups. Results: The mean age of donors was ۳۷yr and ۲۵ (۵۴%) were male. The cause of brain death in ۱۶ (۳۵%) was trauma. The donors’ creatinine level at the admission to the ICU was ۱.۴mg/dl or higher in ۲۰ (۳۵%). The first ۲۴ hours urine output did not significantly differ between donors’ creatinine level lower than ۱.۴mg/dl or higher (۵۵۰۰ ± ۲۶۷۸ml and ۴۰۶۸ ± ۳۳۹۹ml, respectively, P=۰.۰۸۳). Similarly the recipient discharge serum Cr level did not significantly differ between two groups (۱.۶۹ ± ۰.۹۷ and ۱.۷۴ ± ۱.۳۴ mg/dl, respectively, P=۰.۸۸۷). Overall ۸ recipients (۱۴%) needed dialysis during first month after transplantation and there was no significant difference between groups (۱۱% and ۲۰%, respectively, P = ۰.۳۲۰). Conclusions: Findings of this preliminary study showed that the outcome of transplanted kidneys from brain-dead donors with Cr level >=۱.۴mg/dl is similar to other patients. So, higher creatinine level is not a good excuse for rejecting the kidneys for transplantation. Because of various confounding factors in the assessment of transplanted kidney outcome, the future studies with larger sample size and longer follow-up period is recommended.