Deceased-donor kidney transplant following ethylene glycol-induced brain death

We report on a deceased-donor kidney transplant following ethylene glycol-induced brain death. The donor was a 53-year-old man with a history of depression who presented to the emergency department after drinking a "cocktail amount" of windshield wiper fluid each day for the past 3 weeks. Upon presentation he became unresponsive and suffered a seizure. Fomepizole 1.2 g IV followed by emergent hemodialysis was initiated as indicated for acute treatment of ethylene glycol poisoning. Unfortunately, the patient never regained consciousness and progressed to brain death. At the time of procurement his urine output was over 250 mL/h, and serum creatinine was 2.2 mg/dL. Renal biopsy following procurement revealed minimal tubule injury without evidence of intratubular oxalate crystals. The kidney recipient was a 76-year-old woman with end-stage renal disease secondary to diabetes and hypertension. Cold ischemia time was 31 hours, 45 minutes. The only postoperative complication was delayed graft function and one episode of mild acute cellular rejection 7 weeks post transplant that resolved with IV methylprednisolone. Two years post transplant the patient continues to do well clinically with a baseline serum creatinine of 2.5 mg/dL.