title: Increasing Use of the Expanded Criteria for Living Kidney Donation and Good Outcomes of Living Kidney Donors in Korea.
abstract: BACKGROUND
  Donor shortage for kidney transplantation may increase the number of expanded-criteria living donors (ECLDs). We investigated recent trends for ECLD use and the long-term outcomes of living kidney donors.
  
  
  METHODS
  We retrospectively analyzed medical records of 1,144 living kidney donors who donated at the Seoul National University Hospital from 1993 to 2015. The expanded criteria for living donation allow the following: age ≥60 years, body mass index >30 kg/m2, history of hypertension, estimated glomerular filtration rate <80 mL/min, proteinuria or microscopic hematuria, and fasting glucose >100 mg/dL.
  
  
  RESULTS
  The mean age of donors was 40.7 ± 10.8 years, and there were 600 women (52.4%). A total of 466 donors (40.7%) met the ECLD criteria, and the proportion of ECLDs increased over time. Only 5 donors died after donation over a median follow-up of 7 years. No donor developed end-stage renal disease (ESRD). A urine protein-creatinine ratio ≥0.3 g/gCr was found in 14 patients and was more common in the ECLDs than in the standard-criteria living donors. The follow-up loss rate of donors was 59.3% at 5 years.
  
  
  CONCLUSIONS
  Both mortality and ESRD were very rare in carefully selected living kidney donors. However, living donors should be followed more carefully, because the follow-up loss rate was very high and ECLDs are increasingly used.
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Lim
authors.affiliation: Transplantation Research Institute, Seoul National University College of Medicine, Republic of Korea.
authors.forename: E
authors.initials: E
authors.lastname: Jambaldorj
authors.affiliation: Department of Internal Medicine, Sungae Hospital, Seoul, Republic of Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: S S
authors.initials: SS
authors.lastname: Kang
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: T Y
authors.initials: TY
authors.lastname: Koo
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea; Transplantation Research Institute, Seoul National University College of Medicine, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: C
authors.initials: C
authors.lastname: Ahn
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea; Transplantation Research Institute, Seoul National University College of Medicine, Republic of Korea. Electronic address: jcyjs@dreamwiz.com.
authors.forename: J
authors.initials: J
authors.lastname: Yang
mesh_terms: D000328:Adult; D001786:Blood Glucose; D004608:Eligibility Determination; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D018149:Glucose Intolerance / Q000453:epidemiology; D006417:Hematuria / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009392:Nephrectomy / Q000009:adverse effects*; D009765:Obesity / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011507:Proteinuria / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*
chemical_list: D001786:Blood Glucose