Objectives: To explore the clinical effect of kidney transplantation from donors with terminal acute renal failure (ARF) and rhabdomyolysis.

Methods: Kidney transplantation from donors with ARF and rhabdomyolysis from January 2012 to December 2015 was retrospectively reviewed. ARF was defined by RIFLE criteria. Rhabdomyolysis was defined by creatinine kinase (CK) level higher than five times normal (＞ 1000U/L) in conjunction with high serum myoblobin.

Results: Eight donors suffered from rhabdomyolysis and ARF with peak CK 10623 ± 3692U/L, peak serum myoblobin 20618 ± 7959μg/L and peak serum creatinine 483 ± 176μmol/L. Three donors received plasmapheresis therapy (1～3 sessions), 2 donors received continuous renal replacement therapy and 1 donor received extra-corporeal membrane oxygenation treatment. Kidneys from these donors were transplanted into 16 recipients with 4 cases (25.0%) of delayed graft function, 4 cases (25.0%) of slow graft function and 8 cases of normal graft function. With a follow-up of 6 - 46 months, both patient and kidney graft survival were 100%. Mean 6 and 12-month glomerular filtration rate were 65.4 ± 13.5 and 71.2 ± 14.3 mL/(min•1.73m2) respectively.

Conclusions: Kidneys from donors with terminal ARF caused by rhabdomyolysis have excellent short-term outcomes. Screening for rhabdomyolysis should be recommended in deceased donors with acute renal injury.