Abstract
Kidney transplantation is the best treatment option for end stage renal disease. As a result of disparity between the demand for kidney transplantation and the supply of suitable organs, kidneys from suboptimal donors have been used in kidney transplantation. Since demonstration of better patient survival, using marginal donor kidney rather than remaining on he-modialysis, more expanded criteria for donor kidneys were adopted in kidney transplantation. Several donor scoring systems, including Nyberg's donor scoring system, donor risk score by Schold, delayed graft function nomogram, kidney donor risk index (KDRI), and histological graft variable have been developed for evaluation of the quality of deceased donor kidneys showing an increased risk for graft dysfunction and loss and for improvement of the stratification; 15% highest risk donors by KDRI and grade C (20∼29 points) and grade D (30∼39 points) by Nyberg's deceased donor scoring system are compatible with the definition of expanded criteria for kidney donors of United Network for Organ Sharing. Utilization of these scoring systems would be very useful in allocation of expanded criteria for donors for improvement of graft and patient survival.
REFERENCES
1). Korean Network for Organ Sharing (KONOS). The sec-ond quarter 2013 transplant statistis [Internet]. Seoul: KONOS;2013. [cited 2013 Nov 20]. Available from. http://www.konos.go.kr.
2). Port FK, Bragg-Gresham JL, Metzger RA, Dykstra DM, Gillespie BW, Young EW, et al. Donor characteristics as-sociated with reduced graft survival: an approach to ex-panding the pool of kidney donors. Transplantation. 2002; 74:1281–6.
3). Metzger RA, Delmonico FL, Feng S, Port FK, Wynn JJ, Merion RM. Expanded criteria donors for kidney transplantation. Am J Transplant. 2003; 3(Suppl 4):114–25.
4). Port FK. Organ donation and transplantation trends in the United States, 2001. Am J Transplant. 2003; 3(Suppl 4):7–12.
5). Nyberg SL, Baskin-Bey ES, Kremers W, Prieto M, Henry ML, Stegall MD. Improving the prediction of donor kidney quality: deceased donor score and resistive indices. Transplantation. 2005; 80:925–9.
6). Schold JD, Kaplan B, Baliga RS, Meier-Kriesche HU. The broad spectrum of quality in deceased donor kidneys. Am J Transplant. 2005; 5(4 Pt 1):757–65.
7). Irish WD, McCollum DA, Tesi RJ, Owen AB, Brennan DC, Bailly JE, et al. Nomogram for predicting the like-lihood of delayed graft function in adult cadaveric renal transplant recipients. J Am Soc Nephrol. 2003; 14:2967–74.
8). Irish WD, Ilsley JN, Schnitzler MA, Feng S, Brennan DC. A risk prediction model for delayed graft function in the current era of deceased donor renal transplantation. Am J Transplant. 2010; 10:2279–86.
9). Rao PS, Schaubel DE, Guidinger MK, Andreoni KA, Wolfe RA, Merion RM, et al. A comprehensive risk quantification score for deceased donor kidneys: the kidney donor risk index. Transplantation. 2009; 88:231–6.
10). United States. Health Resources and Services Administration (HRSA), Organ Procurement and Transplantation Network (OPTN). A guide to calculating and inter-preting the Kidney Donor Profile Index (KDPI) [Internet]. Rockville, MD: Health Resources and Services Administration, U.S. Dept. of Health & Human Services;2013. [cited 2013 Nov 20]. Available from. http://optn.transplant.hrsa.gov/ContentDocuments/Guide_to_Calculating_Interpreting_KDPI.pdf.
11). United States. Health Resources and Services Administration (HRSA), Organ Procurement and Transplantation Network (OPTN). KDRI to KDPI Mapping Table [Internet]. Rockville, MD: Health Resources and Services Administration, U.S. Dept. of Health & Human Services;2013. [cited 2013 Nov 20]. Available from. http://optn.transplant.hrsa.gov/ContentDocuments/KDRI_to_KDPI_Mapping_Table.pdf.
12). Stratta RJ, Rohr MS, Sundberg AK, Armstrong G, Hairston G, Hartmann E, et al. Increased kidney transplantation utilizing expanded criteria deceased organ donors with results comparable to standard criteria donor transplant. Ann Surg. 2004; 239:688–95.
13). Remuzzi G, Cravedi P, Perna A, Dimitrov BD, Turturro M, Locatelli G, et al. Long-term outcome of renal transplantation from older donors. N Engl J Med. 2006; 354:343–52.
14). Remuzzi G, Grinyò J, Ruggenenti P, Beatini M, Cole EH, Milford EL, et al. Early experience with dual kidney transplantation in adults using expanded donor criteria. Double Kidney Transplant Group (DKG). J Am Soc Nephrol. 1999; 10:2591–8.
15). Ojo AO, Hanson JA, Meier-Kriesche H, Okechukwu CN, Wolfe RA, Leichtman AB, et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J Am Soc Nephrol. 2001; 12:589–97.
16). Dahmane D, Audard V, Hiesse C, Pessione F, Bentaarit B, Barrou B, et al. Retrospective follow-up of transplantation of kidneys from ‘marginal’ donors. Kidney Int. 2006; 69:546–52.
17). Smits JM, Persijn GG, van Houwelingen HC, Claas FH, Frei U. Evaluation of the Eurotransplant Senior Program. The results of the first year. Am J Transplant. 2002; 2:664–70.
18). Frei U, Noeldeke J, Machold-Fabrizii V, Arbogast H, Margreiter R, Fricke L, et al. Prospective age-matching in elderly kidney transplant recipients–a 5-year analysis of the Eurotransplant Senior Program. Am J Transplant. 2008; 8:50–7.
19). United Network for Organ Sharing (UNOS). Policy management [Internet]. Virginia: UNOS;2013. [cited 2013 Nov 20]. Available from. http://www.unos.org.
20). Baskin-Bey ES, Kremers W, Nyberg SL. A recipient risk score for deceased donor renal allocation. Am J Kidney Dis. 2007; 49:284–93.
21). Suárez JF, Riera L, Franco E, Ruiz R, Roig M, Torras J, et al. Preservation of kidneys from marginal donors with pulsatile perfusion machine. Transplant Proc. 1999; 31:2292–3.
22). Land W, Schneeberger H, Schleibner S, Illner WD, Abendroth D, Rutili G, et al. The beneficial effect of human recombinant superoxide dismutase on acute and chronic rejection events in recipients of cadaveric renal transplants. Transplantation. 1994; 57:211–7.
23). Reutzel-Selke A, Jurisch A, Denecke C, Pascher A, Martins PN, Kessler H, et al. Donor age intensifies the early immune response after transplantation. Kidney Int. 2007; 71:629–36.
24). Novick AC, Hwei HH, Steinmuller D, Streem SB, Cunningham RJ, Steinhilber D, et al. Detrimental effect of cyclosporine on initial function of cadaver renal allografts following extended preservation. Results of a rando-mized prospective study. Transplantation. 1986; 42:154–8.
25). Grinyo JM, Gil-Vernet S, Cruzado JM, Caldes A, Riera L, Seron D, et al. Calcineurin inhibitor-free immunosu-ppression based on antithymocyte globulin and mycophenolate mofetil in cadaveric kidney transplantation: results after 5 years. Transpl Int. 2003; 16:820–7.
26). Kappel B, Olsen S. Cortical interstitial tissue and scle-rosed glomeruli in the normal human kidney, related to age and sex. A quantitative study. Virchows Arch A Pathol Anat Histol. 1980; 387:271–7.