Kidney donor profile in Spain: risks factors and characteristics of the organs rejected for transplantation.
B Miranda, J Canón, M T Naya, N Cuende, G Garrido, E Fernández-Zincke
Ann Transplant 2003; 8(2): 9-16
During recent years organ donation in Spain has increased by 100%, withimportant changes seen in the donor profile. Mean age has increased by more than 10 years, being nowadaysmore than 33% of our donors over 60 years. Ten years ago road traffic trauma was the main cause of death,while now most of our donors die due to stroke and only 21% die in a traffic accident. This changes leadto an increase in the number of kidneys discarded for transplantation every year. Among the 2517 kidneysretrieved during 2001, 567 were discarded, mainly due to different glomerular, interstitial or vascularpathologic damage. The older is the donor the higher is the percentage of kidneys discarded. It has tobe underlined that an increased number of livers from donors, whose kidneys could not be used, are beinggrafted (141 in 2001 over 281 donors from whom no kidney could be grafted and over a total number of1335 donors). Only 5% of kidneys were discarded due to technical problems. An important number of kidneyswere discarded due to malignancy suspicion or diagnosis (12.3%). Organ donation has improved but kidneytransplantation did not in parallel, due to the increasing number of kidneys discarded for transplantationin close relation with the evolution of donor's characteristics. Organ donation rate is around 33 donorsper million population while efficient organ donation rate is around 30 donors per million. Only from67% of donors both kidneys can be grafted and from 20% of donors no kidney can be used. These data willnot change our policy, at least by the moment, we will continue to evaluate every potential brain deathdonor with the aim of studying if organs can be used. It is true that in 50% of cases over 70 years noorgan can be used after retrieval and microscopic exam, but in the other 50% we can proceed.