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21 May 2009

Appropriate renal recipient selection in case of kidney procured from expanded criteria donor

P Domagała, A Kwiatkowski, M Wszoła, K Ostrowski, L Pączek, M Durlik, A Chmura

Ann Transplant 2009; 14(1): 55-55 :: ID: 880401

Abstract

Background: Using expanded criteria donor's (ECD) organs is one of the
strategies for making more transplants available. Expanded criteria donor is
defined as a donor older than 60 years or a donor older than 50 years with at least two of the following: hypertension, stroke as a cause of death or serum creatinine greater than 1.5 mg/dl. Appropriate selection of the recipient of such a kidney is crucial to satisfactory results of transplantation. Aim: The aim of this study was to evaluate the role of appropriate selection of the renal recipient of kidney procured from expanded criteria donor.
Material/Methods: One hundred and seventy two patients received cadaveric renal transplants between January 1[sup]st[/sup], 2006 and August 31[sup]st[/sup], 2008. Data on donors, recipients and preservation of kidney was collected. Patient's and graft's survival, as well as immediate, delayed and slow graft function were
analysed. Kidney's function was assessed by serum creatinine concentration and creatinine clearance according to Cockroft-Gault formula at seven days, 1, 3, 6, 12 and 24 months post transplantation. The follow-up was completed on November 30[sup]th[/sup], 2008.
Results: Average 1-year graft survival was 86.9% for the whole group and the
mean creatinine concentration was 1.58 mg/dl. One case of primary nonfunction was observed (0.6%). More than 25% of transplanted kidneys were harvested from ECD. Recipients of expanded criteria donor organs were older, had higher body mass index, had experienced more acute coronary episodes in the past, less frequently had induction of immunosuppressive treatment in comparison to recipients of standard criteria donor's (SCD) organs. Moreover, kidneys harvested from ECD had longer cold ischemia time and more frequently were stored by machine perfusion.
Conclusions: Careful recipient's selection is recommended in cases of expanded criteria donor kidneys in order to diminish factors that can negatively affect patient's and graft's survival.

Keywords: Kidney Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358