title: Outcomes of expanded-criteria deceased donor kidney transplantation in a single center.
abstract: BACKGROUND
  In an effort to expand the deceased donor pool, transplant centers have accepted expanded-criteria donors as appropriate for many of the patients in the deceased donor pool. We investigated expanded-criteria deceased donor kidney transplantation and compared the outcomes of kidney transplantation according to donor types.
  
  
  METHODS
  We retrospectively analyzed 88 kidney transplantations performed between June 2006 and December 2012. We divided the patient into 4 groups: SCDD, standard-criteria deceased donor; ECDD, expanded-criteria deceased donor; ECMO, donor under extracorporeal membrane oxygenation support; living donor.
  
  
  RESULTS
  Deceased and living donor kidney transplantations were performed in 52 (59.1%) and 36 (40.9%) cases, respectively. Among deceased donors, 31 (35.2%) were standard-criteria donors and 14 cases (15.9%) were expanded-criteria donors. Seven (8.0%) donors were under extracorporeal membrane oxygenation support. Mean follow-up was 26.1 ± 20 months. Average number of HLA mismatches among the donor types was 3.39, 3.07, 3.0, and 2.94 in SCDD, ECDD, ECMO, and living donor groups, respectively (P = .708). Delayed graft function occurred in 2 (6.9%), 3 (21.4%), 3 (42.9%), and 3 (8.3%) patients in the SCDD, ECDD, ECMO, and living donor groups, respectively (P = .043). Episodes of acute rejection within a year occurred in 14 (45.2%), 2 (14.3%), 1 (14.3%), and 6 (16.7%) patients in the SCDD, ECDD, ECMO, and living donor groups, respectively (P = .029). Renal functions after kidney transplantation at 3 months, 6 months, 9 months, and 1 year were not significantly different according to donor types. Graft survival was not different among the different donor types (87.1%, 92.8%, 85.7%, 91.7% in SCDD, ECDD, ECMO, and living donor groups, respectively; P = .67). Patient survival was not different among the different donor types (87.1%, 92.9%, 100%, 97.2% in SCDD, ECDD, ECMO, and living donor group, respectively; P = .36).
  
  
  CONCLUSIONS
  The use of expanded-criteria deceased donor had no impact on graft or patient survival after kidney transplantation.
authors.affiliation: Department of Surgery, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: B S
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Surgery, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea. Electronic address: sunhyung@chol.com.
authors.forename: S H
authors.initials: SH
authors.lastname: Joo
authors.affiliation: Department of Surgery, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Ahn
authors.affiliation: Department of Surgery, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: H C
authors.initials: HC
authors.lastname: Park
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002423:Cause of Death; D051799:Delayed Graft Function / Q000209:etiology; D046148:Donor Selection; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006648:Histocompatibility; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D019520:Living Donors / Q000600:supply & distribution; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome