Expanded Criteria Living Donors: How Far Can We Go?

Serur, David; Charlton, Marian

doi:10.7182/pit2012244

Cited by 4 publications

(2 citation statements)

References 32 publications

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“…4 These advances have increased the number of patients who are eligible for renal transplantation although the availability of donor organs has remained stable. 5 Various strategies have been developed to increase the number of available renal grafts, including the elaboration and adoption of Expanded Donor Criteria (ECD) 6,7 and the practice of donation after cardiac death (DCD). 8,9 Their use has lowered mortality rates among patients on waiting lists, but the chances of actually receiving a kidney remain slim: only 9.65% undergo transplantation after a wait of 12 months, and the success rate after 36 months is only 21.65% (www.unos.org).…”

Section: Introductionmentioning

confidence: 99%

Creation and implantation of acellular rat renal ECM-based scaffolds

et al. 2015

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(2015) Creation and implantation of acellular rat renal ECM-based scaffolds, Organogenesis, 11:2, 58-74, DOI: 10.1080/15476278.2015 ABSTRACT. Kidney transplantation is the only potentially curative treatment for patient facing endstage renal disease, and it is now routinely used. Its use is mainly limited by the supply of transplantable donor organs, which far exceeds the demand. Regenerative medicine and tissue engineering offer promising means for overcoming this shortage. In the present study, we developed and validated a protocol for producing acellular rat renal scaffolds.Left kidneys were removed from 26 male Lewis rats (weights: 250-350 g) and decellularized by means of aortic anterograde perfusion with ionic and anionic detergents (Triton X-100 1% and SDS 1%, respectively). 19 scaffolds thus obtained (and contralateral native kidneys as controls) were deeply characterized in order to evaluate the decellularization quality, the preservation of Ó Andrea Peloso, Jacopo Ferrario, Benedetta Maiga, Ilaria Benzoni, Carolina Bianco, Antonio Citro, Manuela Currao, Alessandro Malara, Annalisa Gaspari, Alessandra Balduini, Massimo Abelli, Lorenzo Piemonti, Paolo Dionigi, Giuseppe Orlando, and Marcello Maestri *Correspondence to: Andrea Peloso; Email: andreapeloso@hotmail.it Received August 28, 2014; Revised April 3, 2015; Accepted July 9, 2015. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted. 58 Organogenesis, 11:58-74, 2015 Published with license by Taylor & Francis Group, LLC ISSN: 1547-6278 print / 1555-8592 online DOI: 10.1080/15476278.2015 extracellular matrix components and resultant micro-angioarchitecture structure. The other 7 were transplanted into 7 recipient rats that had undergone unilateral nephrectomy. Recipients were sacrificed on post-transplantation day 7 and the scaffolds subjected to histologic studies.The dual-detergent protocol showed, with only 5 h of perfusion per organ, to obtain thoroughly decellularized renal scaffolds consisting almost exclusively of extracellular matrix. Finally the macro-and the microarchitecture of the renal parenchyma were well preserved, and the grafts were implanted with ease. Seven days after transplant, the scaffolds were morphologically intact although all vascular structures were obstructed with thrombi. Production and implantation of acellular rat renal scaffolds is a suitable platform for further studies on regenerative medicine and tissue engineering.

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Section: Introductionmentioning

confidence: 99%

Creation and implantation of acellular rat renal ECM-based scaffolds

et al. 2015

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“…12 The UK guidelines are in concordance with the findings of this review regarding older age, overweight/obesity, hypertension, and vascular anomalies. Serur et al 147 conducted a similar study on the available data on high-risk donors and the appropriateness of accepting them as live kidney donors. However, in this review, we focused on the most controversial donor criteria for acceptance.…”

Section: Minors As Kidney Donorsmentioning

confidence: 99%

Shifting paradigms in eligibility criteria for live kidney donation: a systematic review

Ahmadi

Lafranca

Claessens

et al. 2015

Kidney International

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As the organ shortage increases, inherently the demand for donor kidneys continues to rise. Thus, live kidney donation is essential for increasing the donor pool. In order to create successful expansion, extended criteria live kidney donors should be considered. This review combines current guidelines with all available literature in this field, trying to seek and establish the optimal extended criteria. Comprehensive searches were carried out in major databases until November 2013 to search for articles regarding older age, overweight and obesity, hypertension, vascular anomalies/multiplicity, nulliparous women, and minors as donors. Of the 2079 articles found, 152 fell within the scope of the review. Five major guidelines were included and reviewed. Based on the literature search, live kidney donation in older donors (up to 70 years of age) seems to be safe as outcome is comparable to younger donors. Obese donors have comparable outcome to lean donors, in short- and mid-term follow-up. Since little literature is available proving the safety of donation of hypertensive donors, caution is advised. Vascular multiplicity poses no direct danger to the donor and women of childbearing age can be safely included as donors. Although outcome after donation in minors is shown to be comparable to adult donors, they should only be considered if no other options exist. We conclude that the analyzed factors above should not be considered as absolute contraindications for donation.

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