title: Expanding the pool of kidney donors: use of kidneys with acute renal dysfunction.
abstract: Given the shortage of organs transplantation, some strategies have been adopted by the transplant community to increase the supply of organs. One strategy is the use of expanded criteria for donors, that is, donors aged >60 years or 50 and 59 years, and meeting two or more of the following criteria: history of hypertension, terminal serum creatinine >1.5mg/dL, and stroke as the donor´s cause of death. In this review, emphasis was placed on the use of donors with acute renal failure, a condition considered by many as a contraindication for organ acceptance and therefore one of the main causes for kidney discard. Since these are well-selected donors and with no chronic diseases, such as hypertension, renal disease, or diabetes, many studies showed that the use of donors with acute renal failure should be encouraged, because, in general, acute renal dysfunction is reversible. Although most studies demonstrated these grafts have more delayed function, the results of graft and patient survival after transplant are very similar to those with the use of standard donors. Clinical and morphological findings of donors, the use of machine perfusion, and analysis of its parameters, especially intrarenal resistance, are important tools to support decision-making when considering the supply of organs with renal dysfunction.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Ana Cristina Carvalho de
authors.initials: AC
authors.lastname: Matos
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Lúcio Roberto
authors.initials: LR
authors.lastname: Requião-Moura
authors.affiliation: Instituto Israelita de Responsabilidade Social, São Paulo, SP, Brazil.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Clarizia
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Marcelino de Souza
authors.initials: Mde S
authors.lastname: Durão Junior
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Eduardo José
authors.initials: EJ
authors.lastname: Tonato
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Rogério
authors.initials: R
authors.lastname: Chinen
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Érika Ferraz de
authors.initials: ÉF
authors.lastname: Arruda
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Thiago Corsi
authors.initials: TC
authors.lastname: Filiponi
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Luciana Mello de Mello Barros
authors.initials: LM
authors.lastname: Pires
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Ana Paula Fernandes
authors.initials: AP
authors.lastname: Bertocchi
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pacheco-Silva
mesh_terms: D058186:Acute Kidney Injury / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000401:mortality; D046148:Donor Selection / Q000458:organization & administration; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D018579:Patient Selection; D015996:Survival Rate; D014019:Tissue Donors / Q000600:supply & distribution*
chemical_list: D003404:Creatinine