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Objectives: To evaluate clinical outcome in dogs after renal transplantation and determine predictors of outcome., Study Design: Retrospective case series., Animals: Dogs (n = 26) that had renal allograft transplantation., Methods: Medical records (1994-2006) of 26 consecutive cases of dogs that had kidney transplantation were reviewed. History, signalment, pre- and postoperative clinicopathologic and monitoring variables, postoperative complications, immunosuppressive therapy, and survival were recorded., Results: Median survival was 24 days (range, 0.5 to 4014 days) with a probability of survival to 15 days of 50% and the 100-day survival probability was 36%. Cause of death was attributed to thromboembolic disease in 8 dogs, infection in 6 dogs, and rejection in 1 dog. The only factor significantly associated with an increased likelihood of death was increasing age at time of surgery (P = .024)., Conclusions: Canine renal transplantation in clinical patients is associated with a high morbidity and mortality and increasing recipient age has a negative association with outcome. Thromboembolic complications are a major cause of death in the immediate postoperative period and effective anticoagulation protocols may greatly improve survival in the future., (© Copyright 2012 by The American College of Veterinary Surgeons.)

Objective: To report the prevalence of hypophosphatemia after renal transplantation in a historical cohort of cats., Design: Case series., Animals: Cats (n=86) that received a renal allograft., Methods: Medical records (January 200-June 2006) were reviewed. Signalment, clinical signs, pre- and postoperative diet, pre- and postoperative clinicopathologic variables, renal histopathology, and outcome were retrieved. Prevalence, onset, duration, treatment and associated clinical signs of hypophosphatemia were recorded. A chi(2) test was used to compare hemolysis frequency between cats with normal serum phosphorus concentration or a single spurious low serum phosphorus concentration for <24 hours duration (group 1) and confirmed hypophosphatemia for >24 hours (group 2). A Cox proportional hazards model was used to evaluate the effects of hypophosphatemia on survival while controlling for other potentially confounding variables (age, sex, weight, body condition score, and pre- and 24 hours postoperative clinicopathologic variables)., Results: Eighty-six cats (mean age, 7.7 years) were identified. Hypophosphatemia occurred in 32 cats (37%), with a median onset of 2 days and median duration of 4 days. Treatment was initiated in 48 (56%) of hypophosphatemic cats. Survival and hemolysis frequency was not significantly different between groups, and no risk factors were identified., Conclusion: Hypophosphatemia occurs in cats after renal transplantation and does not affect survival., Clinical Relevance: The clinical importance of hypophosphatemia in renal transplant recipients remains unknown.

Objective: To determine the relative importance of ischemic injury to delayed graft function (DGF) in cats., Study Design: Experimental study., Animals: Six intact female cats., Methods: Cats had renal autograft transplantation without ureteral transection and reimplantation and a contralateral nephrectomy. Serum creatinine and blood urea nitrogen (BUN) concentrations were measured regularly and abdominal ultrasound was performed before surgery, the day after surgery and twice weekly thereafter. Ultrasound-guided renal biopsy was performed on day 7. Cats were euthanatized on day 21. Histology of the autograft, ureter, bladder, vascular anastomoses sites, and contralateral kidney were performed. Observations were compared with those from an historic group of research cats that had extravesicular ureteroneocystostomy and contralateral nephrectomy., Results: Five cats completed the study. Serum creatinine and BUN concentrations increased after surgery, peaking at 3.2+/-0.8 and 77.6+/-15.9 mg/dL, respectively, 1-2 days after surgery. Serum creatinine concentration returned to the reference interval by 6 days after surgery. BUN gradually decreased in all cats but did not return to the reference interval by study end. Serum creatinine and BUN concentrations were consistently lower but not significantly so (P=.29 and .56, respectively) compared with the historic ureteroneocystostomy group. No ultrasonographic abnormalities or renal biopsy histologic abnormalities were observed. At necropsy, 1 autograft had generalized interstitial fibrosis., Conclusion: Harvesting the renal graft and the ischemia before revascularization causes impaired renal function after engraftment., Clinical Relevance: The process of harvesting and reimplanting the renal graft can contribute to DGF in cats, independent of ureteral obstruction.