Kidney transplantation from marginal donors.
OBJECTIVE
The increasing demand for transplantation and the shortage of available organs limit the success of organ transplant programs. The use of marginal donors to expand the donor pool is receiving increased attention. We reviewed a 28-month experience of kidney transplants from marginal donors to assess the impact on patient and graft survival.


METHODS
From January 2001 to May 2003, 78 kidney transplants were performed, including 50 grafts from cadaver donors and 28 from living donors with 3 patients receiving a double kidney transplant. The patients were divided into 4 groups: 31 patients received a kidney from an ideal cadaver donor (group 1a); 19 patients received a graft from a marginal cadaver donor (group 1b); 19 patients received an ideal living related kidney (group 2a); and 9 patients received a marginal living kidney graft (group 2b).


RESULTS
Twenty-eight grafts from marginal donors were transplanted with an average follow-up of 16 months (range, 1-28 months). The graft survival rates for groups 1a, 1b, 2a, and 2b were 93%, 79%, 100%, and 100% and patient survival rates were 96%, 89%, 100%, and 100%, respectively.


CONCLUSIONS
Despite the observation that use of marginal donors has been associated with a worse outcome compared with ideal donors, we of such grafts resulted in improved quality of life and survival expectancy compared with maintenance dialysis. The marginal kidney donors represent a feasible way to improve the donor pool.
Veroux
P
P
Department of Surgery, Transplantation and Advanced Technologies, Organ Transplant Unit, University Hospital of Catania, Catania, Italy. pveroux@unict.it
Puliatti
C
C
Veroux
M
M
Cappello
D
D
Macarone
M
M
Puliatti
D
D
Vizcarra
D
D
D002102:Cadaver; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D016019:Survival Analysis; D014019:Tissue Donors / Q000145:classification*; D016896:Treatment Outcome