Steroids in Cadaveric Donor Don't Benefit Kidney Recipient
Pre-harvest treatment of deceased donors does not reduce renal failure compared with placebo
WEDNESDAY, Aug. 18 (HealthDay News) -- Treating deceased kidney donors with corticosteroids in advance of kidney harvesting does not reduce the incidence or duration of acute renal failure (ARF) after transplantation in organ recipients, according to a study in the Aug. 17 issue of the Annals of Internal Medicine.
Alexander Kainz, Ph.D., of the Medical University of Vienna in Austria, and colleagues randomized 306 deceased kidney donors to intravenous infusion of either methylprednisolone or a saline placebo at least three hours before harvesting the organs. The researchers observed the incidence of post-transplantation ARF among the 455 transplant recipients. Other study end points included duration of renal failure, serum creatinine level, and genomic evidence of suppressed immune response and inflammation.
The researchers found that 22 percent of the patients with kidneys from steroid-treated donors and 25 percent with kidneys from placebo-treated donors experienced ARF. The median ARF duration was five days in the steroid group and four days in the placebo group (P = 0.31). First-week trajectories of serum creatinine levels were similar in the two groups (P = 0.72). However, genomic analysis showed suppressed inflammation and immune response in biopsies of the kidneys that received steroids.
"In summary, our study showed that steroid pretreatment of deceased organ donors suppressed inflammation in the transplanted kidney but did not reduce the incidence of ARF. Therefore, we do not recommend routinely pretreating deceased organ donors with corticosteroids," the authors write.