Excellent outcome using "impaired" standard criteria donors with elevated serum creatinine.
BACKGROUND
To maximize organ utilization, the United Network for Organ Sharing (UNOS) encourages use of Expanded Criteria Donors (ECD). However, Standard Criteria Donors (SCD) may also be under-utilized, some centers discarding kidneys with serum creatinine (S.Cr) >2.0 at nephrectomy. Our experience with the use of such "impaired'' kidneys was reviewed retrospectively.


RESULTS
From January 1, 2003 to October 1, 2006, of 130 DD kidneys transplanted at our center, 26 were ECD. Also, 22 kidneys were from Impaired SCD (ISCD), with mean S.Cr 3.2 (2.1-4.4) at nephrectomy; eight of these had S.Cr >4.0. For these 22 ISCD, mean age was 22 yrs (11-42), sex: 16 Males; race:12 Caucasians/10 African-Americans; All had evidence of rhabdomyolysis (Mean peak CPK 11,924 u/l). Thirty-seven percent came from outside OPOs. Recipient demographics: age 45 years; sex 50% male, 45% African-American. Mean HLA match was 1; dialysis was required in 28% within the first week. Mean length of stay was 10.7 days. Average discharge S.Cr was 4.2. All kidneys are currently functioning (S.Cr at 3 months, 6 months and 1 year 1.6, 1.7 and 1.7 respectively).


CONCLUSIONS
An elevated creatinine should not be the only cause for discarding deceased donor kidneys.
Greenstein
Stuart M
SM
Department of Surgery, Kidney Transplant Program, Montefiore Medical Center - the University Hospital for the Albert Einstein College of Medicine, Bronx, NY, USA.
Moore
Norman
N
McDonough
Patricia
P
Schechner
Richard
R
Tellis
Vivian
V
D003404:Creatinine / Q000097:blood*; D046148:Donor Selection / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000097:blood; D009927:Tissue and Organ Procurement / Q000592:standards*; D055815:Young Adult
D003404:Creatinine