Abstract: Objective To analyze the impact of a speciic thoracic donor-treatment protocol (including restrictive luid balance) on kidney donation and on kidney graft survival. Methods A cohort study. Lung Donors and kidney recipients from 2003 to 2008 were the pre-protocol cohort, and those from 2009 to 2013 were the protocol cohort. The main outcome variables were graft survival and rate of kidney donation. Results Kidney donation rates were similar in both periods (86.2 vs. 86.2 %; p > 0.05). Both donors and kidney recipients were older and with more comorbidities in the protocol group and this is the reason there were more cases of delayed graft function (diferences not statistically signiicant) and with higher sequential creatinine levels of kidney recipients during the protocol period. However, graft survival was similar in both groups. The probability of graft survival 5 years after transplantation was 0.75 (95 % conidence interval 0.65?0.85) in the pre-protocol cohort and 0.81 (0.70?0.92) in the protocol cohort. Conclusions Speciic treatment for multi-organ donors including restrictive luid balance does not afect kidney donation or kidney graft loss, and has no impact on longterm viability. Hemodynamics must be closely monitored by medical personnel with speciic training.

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