Renal Transplantation from Expanded Criteria Donors

Binnani, Pooja; Bahadur, Madan M.; Gandhi, Bhupendra

doi:10.5772/28187

Cited by 3 publications

(12 citation statements)

References 36 publications

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“…However, it is controversial to accept kidneys from donors with nephrolithiasis because of the lack of long-term results of renal transplantations from nephrolithic living marginal donors. Previous data on patients who underwent nephrectomy or with two kidneys suggested that the possibility of recurrence of kidney stones both in the donor and in the recipient is quite high in renal transplantation from nephrolithic donors with inherited disorder, inflammatory bowel disease, or systemic disease history [9,39]. The usual practice is to accept kidneys from donors without any stones and with normal calcium, urate, and oxalate levels before renal transplantation [8,9].…”

Section: Nephrolithic Donorsmentioning

confidence: 98%

“…Previous data on patients who underwent nephrectomy or with two kidneys suggested that the possibility of recurrence of kidney stones both in the donor and in the recipient is quite high in renal transplantation from nephrolithic donors with inherited disorder, inflammatory bowel disease, or systemic disease history [9,39]. The usual practice is to accept kidneys from donors without any stones and with normal calcium, urate, and oxalate levels before renal transplantation [8,9]. However, living marginal donors with nephrolithiasis can be accepted for renal transplantation if only one stone was formed (less than 1.5 cm in size) and if the donor is screened free for any metabolic abnormalities or urinary infections [8].…”

Section: Nephrolithic Donorsmentioning

confidence: 99%

“…Because the long-term outcome is not clear and there are a number of risks in renal transplantation from aged living donors, the usual practice in both United States and Europe is to use kidneys from aged living or deceased donors in elderly transplantation: the so-called "old-for-old" program [9,25]. This approach makes it possible for elderly ESRD patients to get more access to renal transplantation from expanded criteria deceased donor kidney and living marginal donors, whereas the distribution of optimal kidney donations is toward younger patients [26].…”

Section: Elderly Donorsmentioning

confidence: 99%

“…A systolic blood pressure over 140/90 mm Hg is an important cardiovascular risk during and after renal transplantation both for the donor and for the recipient [9,27]. It is generally accepted that a donated kidney from a living donor over 50 years of age and a normal blood pressure on therapy with a GFR higher than 80 mL/min and proteinuria lower than 300 mg/day can be used in renal transplantation [28,29].…”

Section: Hypertensive Donorsmentioning

confidence: 99%

“…The difference is the point of focus; whereas expanded criteria definition focuses on the quality of donated graft, marginal living donor also emphasizes the potential harm of organ removal to the donor in the long-term. Both definitions describe renal transplantations of suboptimal quality grafts from cadaver, noneheart-beating donors, or living donors from elderly; hypertensive, diabetic, nephrolithic, or obese patients; or living donors with history of malignancy, with potential transmissible infections or with renal cysts [8,9]. There are certain risks to be accepted in renal transplantation from marginal donors such as delayed graft function or graft failure in the short-and long-term, possibly caused by a prolonged cold or warm ischemia period (depending on the type of marginal donor), increased immunogenicity, impaired ability to repair tissue, and impaired function with decreased nephron mass [6e12].…”

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confidence: 99%

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Marginal Donors in Renal Transplantation

Bozkurt

Kılıç

2015

Transplantation Proceedings

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Section: Nephrolithic Donorsmentioning

confidence: 98%

Section: Nephrolithic Donorsmentioning

confidence: 99%

Section: Elderly Donorsmentioning

confidence: 99%

Section: Hypertensive Donorsmentioning

confidence: 99%

mentioning

confidence: 99%

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Marginal Donors in Renal Transplantation

Bozkurt

Kılıç

2015

Transplantation Proceedings

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Feasible kidney donation with living marginal donors, including diabetes mellitus

Yoshinaga

Araki

Wada

et al. 2021

Immunity Inflam & Disease

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Objectives To compare the donor outcomes of living donor kidney transplantation between standard donors (SDs) and marginal donors (MDs) including diabetic patients (MD + DM). Methods MDs were defined according to Japanese guideline criteria: (a) age >70‐years, (b) blood pressure ≤130/80 mmHg on hypertension medicine, (c) body mass index >25 to ≤32 kg/m2, (d) 24‐h creatinine clearance ≥70 to <80 ml/min/1.73 m2, and (e) hemoglobin A1c > 6.2 or ≤6.5 with oral diabetic medicine. Fifty‐three of 114 donors were MDs. We compared donor kidney functions until 60 months postoperatively. Results No kidney function parameters were different between SDs and MDs. When comparing SD and MD + DM, MD + DM had a lower postoperative eGFR (48 vs. 41 (1 (month), p = .02), 49 vs. 40 (12, p < .01), 48 vs. 42 (24, p = .04), 47 vs. 38 (36, p = .01)) and the percentage of residual eGFR (SD vs. MD + DM: 63 vs. 57 (1 (month), p < .01), 63 vs. 57 (2, p < .01), 64 vs. 56 (12, p < .01), 63 vs. 57 (24, p < .01), 63 vs. 52 (36, p = .02)). However, when MD with a single risk factor of DM was compared to SD, the difference disappeared. Nine out of 12 (75%) MD + DM had ≥2 risk factors. Conclusions Although long‐term observation of donor kidney function is necessary, careful MD + DM selection had the potential to expand the donor pool.

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Comparison of estimated glomerular filtration rate of marginal versus standard renal allograft

Bansal

Rupala

Ghosh

et al. 2021

Indian Journal of Urology

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Introduction: The end-stage renal disease (ESRD) population is increasing worldwide and organ shortage is an important issue. The disparity between the availability of organs and waitlisted patients for transplants has forced many transplant centers across the world to use marginal kidney donors. We assess and compare postoperative estimated glomerular filtration rate (eGFR) in patients who received a graft from marginal renal donor (MRD) versus those who received a graft from standard renal donor (SRD). Methods: A total of 214 patients with ESRD underwent open live donor renal allografting from September 2015 to September 2017. Out of 214 donors, 165 (77.1%) were SRD and 49 (22.9%) were MRD. Post-transplant eGFR was calculated at 2 months for donors and at days 1, 3, 5, and 7 and month 1, 3, 6, and 12 for recipients. Results: There was no statistically significant difference in eGFR of recipients at preoperative and postoperative period between SRD and MRD groups. Although at 12 months of follow–up eGFR was relatively high in SRD group, it did not show any statistically significant difference. The recipient survival rate at 1-year follow-up was 98.2% in SRD and 100% in MRD group. Conclusions: Renal transplant recipients using MRDs have a comparable glomerular filtration rate to SRDs at the end of 1 year. Short-term outcomes in recipients receiving marginal renal grafts were similar when compared to the allograft from standard donors.

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Renal Transplantation from Expanded Criteria Donors

Cited by 3 publications

References 36 publications

Marginal Donors in Renal Transplantation

Marginal Donors in Renal Transplantation

Feasible kidney donation with living marginal donors, including diabetes mellitus

Comparison of estimated glomerular filtration rate of marginal versus standard renal allograft

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