Assessment of deceased donor kidneys using a donor scoring system.
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.
Bang
Kitae
K
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Lee
Han Kyu
HK
Huh
Wooseong
W
Lee
Yu-ji
YJ
Woon
Byun Seung
BS
Ro
Han
H
Hwang
Young-Hwan
YH
Ha
Jongwon
J
Park
Myoung Hee
MH
Kim
Sung-Joo
SJ
Park
Su-Kil
SK
Oh
Ha-Young
HY
Yang
Jaeseok
J
Ahn
Curie
C
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