Utility of Deceased Expanded-Criteria Donors in Kidney Transplantation: A Single-Center Experience

TL;DR

This study examines the outcomes of kidney transplants from deceased donors with standard and expanded criteria, focusing on factors affecting graft survival.

Contribution

The study provides insights into the impact of donor criteria and immunosuppressive therapy on long-term graft survival.

Findings

ECD donors had more cerebrovascular deaths and recipients had higher rates of hypertension and diabetes.

Not using MMF and experiencing acute rejection negatively impacted graft survival over 1, 3, and 5 years.

Expanded criteria donor use is common, but graft survival depends on proper monitoring and treatment.

Abstract

Purpose: The success of solid organ transplantation and the consequent increase in the patients on the waiting list has led to an increased utilization of donor kidneys with a high kidney donor profile index (KDPI)/expanded criteria. In our study, patients who underwent transplantation based on the standard and expanded donor criteria were compared in terms of factors affecting graft survival. Data of patients who underwent transplantation from cadavers with standard and extended criteria (SCD, ECD) between 01 July 2011 and 30 June 2016 were evaluated retrospectively. Donor characteristics, treatment type, response and graft characteristics, 1st-, 3rd-, and 5th-year graft survival, and acute rejection rates were analyzed retrospectively. Recent findings: In terms of the causes of death, cerebrovascular accidents were more common in the ECD group (p < 0.001). Hypertension and diabetes were more common in both donor groups and were detected more frequently in recipients in the ECD group (p < 0.001). The absence of mycophenolate mofetil (MMF) use and the presence of an acute rejection attack adversely affected graft survival at the end of the 1st, 3rd, and 5th years. Summary: The utilization of expanded criteria donors is widespread. Appropriate monitoring of patients undergoing immunosuppressive therapy, especially using mycophenolate mofetil (MMF) and the presence of acute rejection, affect graft survival.

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