Complications of transplantation of kidneys from expanded-criteria donors.
BACKGROUND
Organ shortage is the primary barrier to kidney transplantation. To maximize organ use, organs from expanded-criteria donors (ECDs) have been used increasingly. Expanded-criteria donors are defined as individuals older than 60 years or older than 50 years with at least 2 of the following risk factors: hypertension, stroke as the cause of death, or serum creatinine concentration greater than 1.5 mg/dL.


OBJECTIVE
To assess the incidence of complications posttransplantation in ECD kidneys compared with kidneys from standard-criteria cadaveric donors (SCDs).


METHODS
One hundred seventy-two patients received cadaveric renal transplants between January 1, 2006, and August 31, 2008. Donor and recipient data were collected, as well as patient and graft survival and immediate, delayed, or slow graft function. Complication rates for lymphocele, urinary leak, thrombosis, hematoma, urinary tract infection, and cytomegalovirus infection were recorded. Follow-up was for 3 to 35 months, ending on November 30, 2008.


RESULTS
Overall, mean 1-year graft survival was 86.9%, and mean creatinine concentration was 1.58 mg/dL. One incidence of primary nonfunction (0.6%) was observed. More than 25% of transplanted kidneys were from ECDs. No significant differences were noted in postoperative complications between recipients of ECD or SCD organs.


CONCLUSIONS
The rate of complications in recipients of ECD and SCD kidneys is comparable.
Department of General Surgery and Transplantology, Medical University of Warsaw, Nowogrodzka 59, 02-006 Warsaw, Poland. pdomagal@mp.pl
P
P
Domagala
A
A
Kwiatkowski
M
M
Wszola
J
J
Czerwinski
K
K
Cybula
J
J
Trzebicki
A
A
Chmura
D002102:Cadaver; D002423:Cause of Death; D003404:Creatinine / Q000097:blood; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D005500:Follow-Up Studies; D006085:Graft Survival; D006406:Hematoma / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000502:physiology; D008210:Lymphocele / Q000453:epidemiology; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D014552:Urinary Tract Infections / Q000453:epidemiology
D003404:Creatinine