The impact of donor urine chemical toxicology analysis on outcomes of kidney transplantation

Karim M. Soliman, Christopher Molini, Tessa Novick, Steven Menez, Tibor Fülöp, Edward Kraus, Blaithin A. McMahon

Research output: Contribution to journalArticle

Abstract

Background: Acceptance of organs from acute chemical intoxicated donors remains controversial and outcomes are insufficiently explored. Methods: This is a single-center retrospective cohort analysis of 484 patients undergoing deceased donor kidney transplantation (DDKT). We assessed the association of positive urine drug screen before transplantation with cohort statistics, delayed graft function (DGF), and graft outcomes at 2 years. Multiple logistical regression (MLR) analysis was used to assess the odds ratio for DGF. Results: Of 484 random DDKTs performed at our institution between January 2010 and October 2015, 280 deceased kidney donors were current drug users. Mean age was 35.4 (15) years, 39% male, 61% were African Americans, and 38.2% had more than one test positive. The main chemical toxins detectable in donor urine were alcohol, heroin, opioid/methadone, cocaine, marijuana, benzodiazepines, methamphetamine, ecstasy, and LSD. Single and multiple urine chemical toxicology of kidney donors did not have a significant effect on KT outcomes of DGF and graft failure during a median follow-up (P for odds ratios > 0.05). Conclusions: The use of deceased donor kidney grafts from donors with positive urine chemical toxicology may be a worthwhile method of increasing the availability of scarce donor kidney organs as such exposure to illicit drug(s) is not associated with major adverse transplant outcomes.

Original languageEnglish (US)
Pages (from-to)1173-1178
Number of pages6
JournalInternational urology and nephrology
Volume52
Issue number6
DOIs
StatePublished - Jun 1 2020

Keywords

  • Donor
  • Drugs of abuse
  • Outcomes
  • Renal transplantation
  • Toxicology
  • Urine drug

ASJC Scopus subject areas

  • Nephrology
  • Urology

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