Donor Quality Scoring Systems and Early Renal Function Measurements in Kidney Transplantation

Preimplantation Biopsy Predicts Delayed Graft Function, Glomerular Filtration Rate and Long-Term Graft Survival of Transplanted Kidneys

“…Disparities between need for and availability of organs has increased the use of ECDs (16). In United States, up to 85% of procured ECD kidneys are biopsied (2,17). High grade of glomerulosclerosis is a good predictor of early graft dysfunction (3), so this finding usually leads to organ discharge (18).…”

The role of hypothermic machine perfusion in selecting renal grafts with advanced histological score

“…In our center, we adopted an HMP protocol in which all the ECD kidneys being available for transplantation after the back‐table were perfused with an in‐house HMP. An ECD was defined according to the following definition: (a) a deceased‐brain donor (DBD) aged 60 years or older; or (b) a DBD aged 50–59 years with two or more of the following comorbidities: a history of hypertension, death resulting from cerebrovascular accident, and terminal sCr ≥1.5 mg/dl 3 …”

“…The following recipient‐related data were collected in the postoperative period: daily sCr, need for dialysis, and hospital length of stay. Delayed graft function (DGF) was defined in two different ways: (a) need for dialysis within 7 days from KT, 3 and (b) creatinine reduction ratio at day 7 (CRR7) ≤70%. CRR7 was calculated using the following equation: CRR7(%) = ([sCr0–sCr7] × 100)/sCr0), where sCr0 indicates sCr levels immediately before KT and no later than 6 h after the last dialysis, and sCr7 indicates levels on day 7 post‐KT 13 …”

“…1 However, renal transplants from such donors are often correlated with worse early and late posttransplant results. [2][3][4] Therefore, new strategies have been proposed to improve the graft selection process. For example, pretransplant histological evaluation has been primarily adopted to identify the organs usable for a single KT, a double KT, or discard.…”

“…The resultant growing number of patients waiting for KT has thus pushed for an attendant increase in the number of potential donors, prompting a more liberal use of Expanded Criteria Donors (ECD) 1 . However, renal transplants from such donors are often correlated with worse early and late posttransplant results 2–4 . Therefore, new strategies have been proposed to improve the graft selection process.…”