The impact of donor myelofibrosis on outcome of renal transplantation

Abstract

In donors known to have medical conditions associated with kidney damage, caution is exercised when accepting donor kidneys. Myelofibrosis can affect kidney function in a variety of ways, but is not generally considered a contraindication to donation. We present the case of a 27-year-old woman with known myelofibrosis who died from an upper gastrointestinal bleed. After cardiac death, both the kidneys were donated. The first recipient was a 34-year-old lady with focal segmental glomerular sclerosis in her single pelvic kidney. There was delayed graft function and the kidney continued to function poorly due to a significant donor vascular disease. The second recipient was a 27-year-old man with posterior urethral valves. Similar donor vascular disease caused this transplant to fail. The kidney damage did not fit any pattern reported in myelofibrosis, but may represent part of a spectrum of damage seen with this disease. This case highlights the need for caution when accepting kidneys from donors with chronic medical conditions even when young, and may be of use to transplant teams when considering accepting future donations from patients with myelofibrosis.