title: Complications of kidney transplantation with grafts from expanded criteria donors.
abstract: OBJECTIVE
  The limited availability of kidneys for transplantation has been addressed by expanding the criteria for allowing a donor kidney to be transplanted, but this tendency may cause suboptimal kidneys to be implanted and could be associated with greater risk of complications.
  
  
  METHODS
  A retrospective study of 407 kidney transplantations was done to compare complications of transplantation with non-expanded (n = 244) and expanded criteria donors (n = 163). Expanded criteria donors were donors older than 60 years, or donors aged 50-60 years who had ≥ 2 of the following risk factors: hypertension, diabetes mellitus (type 2), creatinine >1.5 mg/dL, or death caused by stroke.
  
  
  RESULTS
  Compared with transplant recipients from non-expanded criteria donors, transplant recipients from expanded criteria donors had significantly greater frequency of graft loss, delayed graft function, pneumonia, overall surgical complications, early reoperation, wound eventration, hydronephrosis, postoperative hemorrhage, and wound infection. When analyzing surgical complications types, a significant greater frequency of urologic, wound, vascular, early and late surgical complications was found. In terms of severity, expanded donor criteria transplantation was related to Clavien I, III, and IV complications.
  
  
  CONCLUSIONS
  Transplantation of kidneys from expanded criteria donors is associated with a significant higher risk of medical and surgical complications than kidneys from non-expanded criteria donors.
authors.affiliation: Department of Urology, University of Navarra Clinic, P.O. Box 4209, 31008 Pamplona, Spain. jfbarba@unav.es
authors.forename: Javier
authors.initials: J
authors.lastname: Barba
authors.forename: Juan Javier
authors.initials: JJ
authors.lastname: Zudaire
authors.forename: José Enrique
authors.initials: JE
authors.lastname: Robles
authors.forename: David
authors.initials: D
authors.lastname: Rosell
authors.forename: José María
authors.initials: JM
authors.lastname: Berian
authors.forename: Ignacio
authors.initials: I
authors.lastname: Pascual
mesh_terms: D000328:Adult; D000368:Aged; D006084:Graft Rejection / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008137:Longitudinal Studies; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000592:standards*; D016896:Treatment Outcome