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KIDNEY TRANSPLANTATION FROM DECEASED DONORS WITH HIGH TERMINAL SERUM CREATININE

IVA BAČAK KOCMAN ; Zagreb University Hospital Center, Department of Anesthesiology and Intensive Care, Zagreb, Croatia
ŽELJKO KAŠTELAN ; Zagreb University Hospital Center, Department of Urology, Zagreb, Croatia
PETAR KES ; Zagreb University Hospital Center, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
ELEONORA GOLUŽA ; Zagreb University Hospital Center, Department of Anesthesiology and Intensive Care, Zagreb, Croatia
MLADEN PERIĆ ; Merkur University Hospital, Clinical Department of Surgery, Zagreb, Croatia
IVAN KOCMAN ; Zagreb University Hospital Center, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
NIKOLINA BAŠIĆ JUKIĆ ; Zagreb University Hospital Center, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia

Abstract

The ever increasing number of possible recipients of kidney transplantation and the relatively unchanged number of organ donors has led to consideration of alternative strategies and expansion of deceased donor criteria in order to expand donor pool. Previously, kidneys from expanded criteria donors were underestimated strongly because of the conventional opinion suggesting these kidneys to have a higher rate of preservation injury, delayed graft function, rejection and non-function. Reducing the difference between graft outcome from patients transplanted with expanded criteria donor (ECD) and standard criteria donor (SCD) is one of the goals of many respectable kidney transplantation centers. This includes strong concern about reduction of cold ischemia time, recipient selection, novel and adapted immunosuppressive regimens, increased nephron mass by dual kidney transplantation, and using histologic criteria for marginal donor graft selection. There are not many reports about the outcome of transplanted kidneys from donors with acute renal failure and high terminal creatinine. In this review, we have tried to show the exact definition of marginal donor, especially donors with acute renal failure. Management of such grafts during preimplantation and implantation period, outcomes and care after transplantation pose a great challenge to transplantation teams. Recipients of such grafts have to be well informed about the possibilities and potential complications, and give their consent accordingly. Some respectable studies have shown that under certain, highly controlled conditions, these kidneys can be used safely, with excellent short- and longterm outcomes.

Keywords

renal transplantation; expanded criteria donor; outcome

Hrčak ID:

180163

URI

https://hrcak.srce.hr/180163

Publication date:

6.4.2017.

Article data in other languages: croatian

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