Effect of Vasoactive Therapy Used for Brain-Dead Donors on Graft Survival After Kidney Transplantation D. Birtan a , M.K. Arslantas b , G.T. Altun b , P.C. Dincer c, *, S. Gecegormez d , A. Demirel d , and H.O. Ayanoglu c a Transplantation Coordination Unit, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey; b Anaesthesiology and Reanimation Department, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey; c Anaesthesiology and Reanimation Department, Marmara University, School of Medicine, Istanbul, Turkey; and d Ministry of Health, Tissue and Organ Transplantation- Istanbul Regional Transplant Coordination Center, Istanbul, Turkey ABSTRACT Serum catecholamine levels and peripheral vascular resistance decrease after brain death. Vasoactive drugs are used to control these hemodynamic changes and to improve perfusion of the organs. These drugs might have a role in rejection or loss of the graft organ. We aimed to investigate the effects of vasoactive drugs used in the cadaveric donor care on post-transplant renal graft functions. In this retrospective study, medical records of 135 cadaveric donors (270 kidneys) and recipients of these kidneys were evaluated. Correlation analysis was done to assess the data for factors that may cause rejection and graft loss. Vasoactive drug (noradrenaline 49%, dopamine 60%, adrenaline 3%, dobutamine 11%) consumption ratio was 85.8% in donor care. Increased number of noradrenaline infusion days was associated with decreased rates of graft rejection and graft loss. This correlation was not found for dopamine. Results of the Pearson correlation analysis test showed a relation between noradrenaline use and decrease in graft loss and graft rejection. Noradrenaline but not dopamine used in cadaveric donor care decreased the graft rejec- tion rate and graft loss, presumably by improving hemodynamic stability and organ perfusion, although we found no special reason. L ONG-TERM survival of the kidney after transplantation is enhanced if catecholamines are used in donor care [1]. Dopamine is widely used as first-line vasoactive agent for treatment of hypotension following brainstem death. Although there are insufficient data in selecting the most effective vaso- active drug to be used in donor care, norepinephrine is rec- ommended in low systemic vascular resistance states [2]. This study aimed to investigate the effects of drugs used in donor care on post-transplant renal graft function, retrospectively. For this reason, organ donations in the hospitals of Ministry of Health Organ and Tissue Transplant Coordination Center of Istanbul Region were evaluated. PATIENTS AND METHODS Medical records of 135 cadaveric donors (270 kidneys) and re- cipients of these kidneys between 2012 and 2013 were retrospec- tively evaluated. Correlation analysis was done to assess the data that may cause rejection and graft loss. Donors age, gender, body mass index (BMI), radiology imaging and radio opaque dye consumption, intensive care unit length of stay, reason of brain death and tests used in diagnosis of brain death, he- modynamic parameters, drugs used (vasoactive drugs, inotropes, antibiotics), blood products consumption, infection; recipients age, gender, BMI, blood type, co-existing diseases, tissue match, cross- clamp time, cold ischemia time, renal function tests and other labo- ratory values, rejection, graft loss, and renal replacement therapy were recorded in the first 24 hours and at 1, 3, 6, 12, and 24 months. RESULTS From 106 donors, 207 kidneys were harvested (35 of them were marginal donors). Rejection of the graft occurred in 32 *Address correspondence to Pelin Corman Dincer, Marmara University, School of Medicine, Anaesthesiology and Rean- imation Department, Marmara University Pendik Research and Training Hospital, Fevzi Çakmak Mah, Muhsin Yazıcıo glu Cad No. 10 Üst Kaynarca, 34899 Pendik, Istanbul, Turkey. Tel: þ90 542 527 00 11, Fax: þ90 216 6570695. E-mail: pelincorman@ yahoo.com ª 2018 Elsevier Inc. All rights reserved. 230 Park Avenue, New York, NY 10169 0041-1345/18 https://doi.org/10.1016/j.transproceed.2018.02.058 Transplantation Proceedings, XX, 1e3 (2018) 1