Results of Expanded-Criteria Donor Kidneys: A Single-Center Experience in Hungary

Background To ease organ shortage, many transplant centers accept kidneys from expanded-criteria donors (ECDs). Our aim was to analyze the results of ECD grafts in our center. Methods Data on cadaveric donors were retrospectively analyzed between January 2011 and September 2014. Definition of ECD was: (1) donor age ≥60 years, (2) donor age 50 to 59 years, and (3) the presence of 2 among the following criteria: hypertension, serum creatinine >1.5 mg/dL, or death from cerebrovascular accident. Standard-criteria donors (SCDs) were those who did not meet the criteria for an ECD. Results During the observation period, 215 cadaveric donors were reported within our region, and 14 kidneys were offered to our center from Eurotransplant. Ninety-one (40%) among the reported donors were ECDs and 123 (54%) were SCDs. The rates of delayed graft function (DGF) and acute rejection (ARE) were not influenced by transplantation of an ECD graft. The cumulative patient and graft survival rates for ECDs were comparable with those of patients who received an optimal graft. Conclusions ECD grafts can be transplanted safely, without the increased risk of DGF, ARE, and inferior patient and graft survival, in the case of careful patient allocation, and with the use of induction therapy.