Effects of Donor Pretreatment With Dopamine on Graft Function After Kidney Transplantation A Randomized Controlled Trial
2009
Context Kidney graft function after transplantation can be improved through pharmacological donor pretreatment to limit organ injury from cold preservation. Objective To determine whether pretreatment of brain-dead donors with low-dose dopamine improves early graft function in human renal transplant recipients. Design, Setting, and Patients Randomized, open-label, multicenter, parallel-group trial of 264 deceased heart-beating donors and 487 subsequent renal transplants performed at 60 European centers between March 2004 and August 2007 (final follow-up, December 31, 2008). Eligible donors were stable under low-dose norepinephrine with a normal serum creatinine concentration on admission. Interventions Donors were randomized to receive low-dose dopamine (4 μg/kg/min). Main Outcome Measures Dialysis requirement during first week after transplantation. Results Dopamine was infused for a median of 344 minutes (IQR, 215 minutes). Dialysis was significantly reduced in recipients of a dopamine-treated graft. Fewer recipients in the treatment group needed multiple dialyses (56/227; 24.7%; 95% CI, 19.0%-30.3%; vs 92/260; 35.4%; 95% CI, 29.5%-41.2%; P = .01). The need for multiple dialyses posttransplant was associated with allograft failure after 3 years (HR, 3.61; 95% CI, 2.39-5.45; P Conclusion Donor pretreatment with low-dose dopamine reduces the need for dialysis after kidney transplantation. Trial Registration clinicaltrials.gov Identifier: NCT00115115
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