title: Assessment of deceased donor kidneys using a donor scoring system.
abstract: OBJECTIVE
  Marginal grafts should be used more actively in Asian countries where deceased donor transplantation is unpopular. We modified a quantitative donor scoring system proposed by Nyberg and his colleagues and developed a donor scoring system in order to assess the quality of deceased donor grafts and their prognostic value as an initial effort to promote usage of marginal donors.
  
  
  METHODS
  We retrospectively evaluated 337 patients.
  
  
  RESULTS
  A scoring system was derived from six donor variables [age, 0-25; renal function, 0-4; history of hypertension, 0-4; Human Leukocyte Antigen (HLA) mismatch, 0-3; body weight, 0- 1; cause of death, 0-3 points]. Donor grafts were stratified by scores: grade A, 0-10; grade B, 11-20; grade C, 21-30; and grade D, 31-40 points. Donor grades significantly correlated with estimated glomerular filtration rate (eGFR) at 6 months (A, 64.0 mL/min/1.73 m(2); B, 57.0 mL/min/1.73 m(2); C, 46.8 mL/min/1.73 m(2); p < 0.001). The five-year graft survival rate was also lower in grade C than grade A (74% vs. 93%, p = 0.002). Donors in grade C and D were regarded as marginal donors. The proportion of marginal donors was much lower in Korea, compared with data from the United Network for Organ Sharing (15.2% vs. 29%).
  
  
  CONCLUSIONS
  Considering the scarcity of deceased donor kidneys and the relatively better graft outcome with lower grade-donors in Korea, it is worth increasing the usage of marginal grafts.
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Kitae
authors.initials: K
authors.lastname: Bang
authors.forename: Han Kyu
authors.initials: HK
authors.lastname: Lee
authors.forename: Wooseong
authors.initials: W
authors.lastname: Huh
authors.forename: Yu-ji
authors.initials: YJ
authors.lastname: Lee
authors.forename: Byun Seung
authors.initials: BS
authors.lastname: Woon
authors.forename: Han
authors.initials: H
authors.lastname: Ro
authors.forename: Young-Hwan
authors.initials: YH
authors.lastname: Hwang
authors.forename: Jongwon
authors.initials: J
authors.lastname: Ha
authors.forename: Myoung Hee
authors.initials: MH
authors.lastname: Park
authors.forename: Sung-Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Su-Kil
authors.initials: SK
authors.lastname: Park
authors.forename: Ha-Young
authors.initials: HY
authors.lastname: Oh
authors.forename: Jaeseok
authors.initials: J
authors.lastname: Yang
authors.forename: Curie
authors.initials: C
authors.lastname: Ahn
mesh_terms: D000293:Adolescent; D000328:Adult; D002102:Cadaver; D003643:Death; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000502:physiology*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D014019:Tissue Donors