title: Excellent outcomes after transplantation of deceased donor kidneys with high terminal creatinine and mild pathologic lesions.
abstract: BACKGROUND
  Outcomes after kidney transplantation using deceased donors with high terminal creatinine are not well described but potentially represent an underutilized source of renal allografts. Utility of renal biopsy of these kidneys is similarly not well established.
  
  
  METHODS
  To better understand the posttransplant function of kidneys from donors with high terminal creatinine, we reviewed our database of almost 500 cadaveric kidney transplants. We compared the 65 nonexpanded criteria donors with a final donor creatinine > or = 2.0 mg/dl (range 2.0-4.9 mg/dl) with kidneys procured from donors with terminal creatinine of <1.5. Biopsy results were correlated with graft function.
  
  
  RESULTS
  Kidneys from deceased donors with high terminal creatinine performed as well as kidneys from donors with a normal terminal creatinine with respect to primary non-function, acute rejection, 6-year graft and patient survival, and function over the first 48 months. High creatinine kidneys with moderate or severe lesions on biopsy demonstrated poorer function at 6 months and 1 year as compared to those with mild or no histological lesions.
  
  
  CONCLUSIONS
  Under select conditions, kidneys from donors with high terminal creatinine can be used safely with excellent results.
authors.affiliation: Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Ugarte
authors.forename: Edward
authors.initials: E
authors.lastname: Kraus
authors.forename: Robert A
authors.initials: RA
authors.lastname: Montgomery
authors.forename: James F
authors.initials: JF
authors.lastname: Burdick
authors.forename: Lloyd
authors.initials: L
authors.lastname: Ratner
authors.forename: Mark
authors.initials: M
authors.lastname: Haas
authors.forename: Alan M
authors.initials: AM
authors.lastname: Hawxby
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Karp
mesh_terms: D000208:Acute Disease; D000328:Adult; D003404:Creatinine / Q000032:analysis*; D003643:Death; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006789:Host vs Graft Reaction; D006801:Humans; D007668:Kidney / Q000473:pathology* / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D003404:Creatinine