Analysis of 75 discarded cadaver kidneys.

Of 431 cadaver kidneys available for transplantation, 75 were discarded after a period of pulsatile perfusion. Kidneys were discarded because of poor flow, multiple arteries with segmental obstruction, prolonged warm ischemia time, perfusion pump malfunction, and lack of donor cells for cross-matching, among other reasons. Certain selected variables common to transplantated kidneys and kidneys discarded have been analyzed. The most significant finding was that 70% of transplanted kidneys came from donors who had recieved pretreatment with either phenoxybenzamine hydrochloride, methylprednisolone sodium succinate, or phentolaminemesylate. Only 33.3% of kidneys discarded were taken from donors who had received such pretreatment (P less than .01). Attention is focused on the need for careful consideration of the technical aspects of donor nephrectomy as well as the need for donor pretreatment, in order to decrease the number of discarded kidneys.