title: Expanding the donor pool--preliminary outcome of kidney recipients from infected donors.
abstract: BACKGROUND
  The number of cadaver donors is far beyond demand. The use of marginal donors may increase the number of organs available for transplantation.
  
  
  METHODS
  We expanded our criteria for cadaver donors to include those with active infections. From January 2004 through August 2005, there were 25 cadaveric transplantations in our center. Infected donors accounted for 13 transplants and the remaining 12 that were not infected were used as the control subjects. Blood and infected locus cultures were performed before transplantation and the recipients were treated accordingly.
  
  
  RESULTS
  There were no statistically significant differences between post-transplantation creatinine levels of the kidneys from infected and non-infected donors at 1 month (1.50 +/- 0.61 vs 2.21 +/- 0.77, p = 0.235) and 3 months (1.33 +/- 0.57 vs 2.31 +/- 0.92, p = 0.311) after transplantation. There were no differences in final creatinine levels (1.25 +/- 0.39 vs 1.81 +/- 0.89, p = 0.077), urinalysis white blood cell count (11.62 +/- 26.64 vs 1.91 +/- 3.30, p = 0.102) and blood white cell count (7677 +/- 1890 vs 8636 +/- 2390, p = 0.635). None of the recipients in the infected donor group developed systemic infections or complications. Graft and patient survival rates were both 100%.
  
  
  CONCLUSIONS
  Our results seem to suggest that kidneys procured from infected donors might be suitable for transplantation without transmission of the infective organism. Nevertheless, prophylactic antibiotics, close monitoring for possible infection and great care are warranted to prevent related complications. However, longer follow-up periods are needed.
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Hsu-Han
authors.initials: HH
authors.lastname: Wang
authors.forename: Sheng-Hsien
authors.initials: SH
authors.lastname: Chu
authors.forename: Kuan-Lin
authors.initials: KL
authors.lastname: Liu
authors.forename: Yang-Jen
authors.initials: YJ
authors.lastname: Chiang
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002102:Cadaver; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000635:transmission; D016030:Kidney Transplantation / Q000592:standards; D014019:Tissue Donors / Q000600:supply & distribution*
chemical_list: D000900:Anti-Bacterial Agents