Results of a prospective allocation policy of expanded criteria donors kidneys based on clinical parameters.
The ideal system to allocate expanded criteria donors (ECD) kidneys has not been fully elucidated. In a previous retrospective study, we reported that donor clinical characteristics were more predictive of transplant outcome than biopsy findings. Subsequently, we decided to use ECD kidneys solely based on a clinical scoring system. To elucidate the value of the pre-transplant biopsy, the patients were divided in two groups according to the suitability of the kidney they received for single or double transplantation as determined by a histological scoring system (HS). All kidneys were transplanted as a single (vs. dual) transplant. We studied whether a HS of the pre-transplant biopsy was predictive of outcome of single transplant ECD kidneys. Recipients (n = 48) were divided into two groups by whether the histologic system suggested single or double transplants be done. There were no differences between groups in two-yr outcomes. We conclude that a clinical scoring system can predict which ECD kidney donors can be safely used as single transplants in a cohort of low immunological risk de novo kidney transplant recipients. Use of the clinical scoring system maximizes organ use.
Re
L
L
Renal Transplantation, Instituto de Nefrologíade Buenos Aires, Argentina. luis_s_re@yahoo.com.ar
Curcio
D
D
Rial
M
M
Goldberg
J
J
Casadei
D
D
D003404:Creatinine / Q000378:metabolism; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000379:methods*
D003404:Creatinine