Methamphetamine use in deceased kidney donors impairs one-yr graft function*

Abstract: Background: Methamphetamine (MA) has cumulative deleterious effects on multiple organ systems. A history of MA exposure in kidney donors may affect adversely graft function in recipients.

Methods: Between September 2000 and March 2004, all deceased kidney donors were identified from the local registry (97 donors). Twenty donors (21%) with any MA exposure through history or toxicology were selected. Donors that did not fulfill UNOS standard criteria were excluded. Donor characteristics and subsequent recipient characteristics were retrospectively compared with a control group without MA exposure histories. The main outcome measure was mean serum creatinine at one-yr post-transplant (Cr³⁶⁵). Secondary outcome measures of delayed graft function and rejection episodes were reviewed.

Results: Baseline serum creatinine at seven d post-transplant were equivalent between groups (Cr⁷ = 2.5 ± 2.0 vs. 2.8 ± 3.4, p = 0.75). At one yr, Cr³⁶⁵ was significantly elevated in recipients of MA exposed kidneys compared with controls (1.9 ± 1.0 vs. 1.4 ± 0.4, p = 0.028). When adjusted for confounding variables, MA exposure lost its statistical significance (p = 0.07–0.09) as an independent predictor of increased Cr³⁶⁵.

Conclusion: Donor MA exposure may be associated with increased Cr³⁶⁵ in recipients. Transplant centers can expect to encounter donors with MA use histories at rates higher that regional use rates. Larger studies may demonstrate MA exposure as an independent predictor of impaired graft function.