title: Outcomes in renal transplantation with expanded-criteria donors.
abstract: BACKGROUND
  Kidney transplantation is the treatment of choice for patients with end-stage renal disease. In recent years donor criteria have changed to increase the percentage of expanded-criteria donors (ECDs). The aim of this study was to analyze transplants from ECDs obtained at our institution from. 2010 to 2012. We studied the comorbidity of ECD, preimplantation histologic study, renal function, and survival of transplanted grafts.
  
  
  METHODS
  Eighty ECDs (160 kidneys) were analyzed. Forty-nine grafts were not implanted owing to macroscopic lesions (37 kidneys) or histologic findings on preimplantation biopsy (12 kidneys). Finally, 60 grafts from ECDs were implanted in our center. We analyzed the characteristics of the grafts (kidney function, creatinine clearance) and compared the data with a control group of allografts from standard-criteria donors (n = 14).
  
  
  RESULTS
  The median age of the ECD group was 72 years (range 65-77). No differences were found in certain characteristics between the ECDs whose kidneys were or were not implanted (hypertension, diabetes, creatinine at the time of the donation or proteinuria). However, there were differences in donor age (75 vs 67; P = .043), increased preimplantation biopsy score (6.8 ± 1.3 vs 4.8 ± 1.1; P = .041), and a higher percentage of cardiovascular disease (62.5% vs 43%; P = .038). Comparison of ECD and non-ECD grafts showed a lower creatinine clearance at 1 year (50 ± 05 mL/min vs 69 ± 96 mL/min, respectively; P < .001) and 2 years (50 ± 07 mL/min vs 67 ± 74 mL/min; P < .001) after transplantation. There were no differences in delayed graft function or graft survival between the 2 groups at 2 years after transplantation (95% vs 100%; P = .38).
  
  
  CONCLUSIONS
  We found no differences in graft survival from ECD compared with the control group of standard-criteria donors. The evaluation of grafts from ECD may be a strategy to increase the number of kidney transplants.
authors: Nephology Unit, University Hospital Reina Sofia, Cordoba, Spain.
authors: S
authors: S
authors: Martínez-Vaquera
authors: M D
authors: MD
authors: Navarro Cabello
authors: M
authors: M
authors: López-Andreu
authors: J M Dueñas
authors: JM
authors: Jurado
authors: C Rodelo
authors: CR
authors: Haad
authors: R Ortega
authors: RO
authors: Salas
authors: A Rodríguez
authors: AR
authors: Benot
authors: J P Campos
authors: JP
authors: Hernández
authors: J C Robles
authors: JC
authors: Arista
authors: P
authors: P
authors: Aljama
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000209:etiology / Q000503:physiopathology; D046148:Donor Selection; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine