Improved scoring system to assess adult donors for cadaver renal transplantation.
We previously proposed a quantitative approach to assess donor organs for cadaver renal transplantation. To improve on our original scoring system, we studied 34 324 patients who received cadaver renal transplants from adult donors between 1994 and 1999 and were reported to the UNOS Scientific Renal Transplant Registry. A scoring system was developed from five donor variables (age, 0-25 points; history of hypertension, 0-4; creatinine clearance before procurement, 0-4; cause of death, 0-3; HLA mismatch, 0-3) that showed a significant correlation with renal function and long-term graft survival. Cadaver kidneys were stratified by cumulative donor score: grade A, 0-9 points; grade B, 10-19; grade C, 20-29; and grade D, 30-39. The influence of donor score on renal function and graft survival was most severe above 20 points, designated 'marginal' kidneys. In summary, a donor scoring system developed from a large population database was useful in predicting outcome after cadaver renal transplantation. The improved system provides a quantitative approach to evaluation of marginal kidneys and may improve allocation of these organs in cadaver renal transplantation.
Nyberg
Scott L
SL
Division of Transplantation Surgery, Mayo Clinic, Rochester, MN, USA. Nyberg.Scott@mayo.edu
Matas
Arthur J
AJ
Kremers
Walter K
WK
Thostenson
Jeffrey D
JD
Larson
Timothy S
TS
Prieto
Mikel
M
Ishitani
Michael B
MB
Sterioff
Sylvester
S
Stegall
Mark D
MD
D000328:Adult; D000367:Age Factors; D002102:Cadaver; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation; D011237:Predictive Value of Tests; D014019:Tissue Donors / Q000145:classification
D006680:HLA Antigens