Renal transplants using expanded cadaver donor criteria.
OBJECTIVE
to analyze the frequency of transplants using expanded donor criteria (EDC) and the incidence of delayed graft function, acute rejection and the patient and graft survival compared to ideal donors (ID).


METHODS
retrospective analysis of the 582 cadaver renal transplants performed from Jun 1988 to Mar 2003 in adult recipients. The expanded donor criteria were considered as history of hypertension or evidence of atherosclerosis, diabetes, age less than 5 or more than 55 years old, serum creatinine higher than 2.0 mg/dL, shock and retrieval in cardiac arrest. The statistical analysis used was Student t test, Chi-square test, and Kaplan-Meier method as indicated.


RESULTS
25.4% of our transplants used expanded criteria donor. Comparing, respectively, the EDC and ID we found: the incidence of delayed graft function of 63.9% vs 50.4% (P: 0.007); incidence of acute rejection of 66.1% vs 72.3% (P: 0.203). The patient survival at 1 and 5 years was 87% vs 92% and 81% vs 79%, respectively (P: 0.6809). The graft survival at 1 and 5 year was 74% vs 82% and 57% vs 59% (P: 0.2072), respectively for EDC and ID.


CONCLUSIONS
One fourth of our cadaver transplants fulfilled the extended donor criteria. The incidence of delayed graft function was higher in these transplants, but the prevalence of rejection episodes was similar to ideal donors. The patient and graft survival were not statistically different at 1 and 5 year.
Nephrology, Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre-RS-Brazil. keitel@terra.com
Elizete
E
Keitel
Tatiana
T
Michelon
Auri Ferreira
AF
dos Santos
Antônio Eduardo
AE
Bittar
João Carlos
JC
Goldani
Patricia
P
D'almeida Bianco
Rosana Mussoi
RM
Bruno
Alexandre
A
Losekann
Alexandre Augusto
AA
Messias
Dolores
D
Bender
João Jorge
JJ
Bianchini
Valter
V
Duro Garcia
D001938:Brazil / Q000453:epidemiology; D002102:Cadaver; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D018579:Patient Selection; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods