Is there a limit for expanding criteria of kidney donors? How far can we go?

Piotr Domagala¹, Artur Kwiatkowski¹, Rafal Kieszek¹, Michal Wszola¹, Jakub Drozdowski¹, Piotr Diuwe¹, Andrzej Chmura¹

¹Department of General Surgery and Transplantology, Medical University of Warsaw, Warszawa, Poland

Introduction

The lack of organs for transplantation has forced the transplant community to expand the pool of donors. Using expanded criteria donor (ECD) organs is one of the strategies for making more transplants available. Although there are organs that do not fit into definition of ECD and remains controversial for transplantation. The aim of this paper is to report the criteria of discharging kidney from transplantation.

Patients and methods

Four hundred and sixteen patients received cadaveric renal transplants between January 1, 2010 and June 31, 2013. In this time seventy one kidneys were discharged from the transplantation – thirty eight kidneys (nineteen referred potential donors) were disqualified before organ procurement and thirty three kidneys were rejected from transplantation during organ storage. Data on donors and preservation parameters were collected. Causes of organ refusal were analysed.

Results

Two the most common causes of kidney rejection from transplantation were malignancy or strong suspicion of malignancy in donor body as well poor donor kidney parameters with probability of kidney irreversible injury.

Conclusion

Careful kidney selection is recommended in cases of expanded criteria donor kidneys in order to diminish factors that can negatively affect graft function and survival.