Expanded Criteria Donors.
10.4285/jkstn.2010.24.3.159
- Author:
Young Hoon KIM
1
;
Mi Ri LEE
Author Information
1. Department of Surgery, Dong-A University College of Medicine, Busan, Korea. yhkim1@dau.ac.kr
- Publication Type:Review
- Keywords:
Expanded criteria donor;
Donor age;
Allocation
- MeSH:
Brain Death;
Cold Ischemia;
Counseling;
Creatinine;
Death;
Hepatitis B;
Humans;
Hypertension;
Kidney;
Liver;
Liver Transplantation;
Living Donors;
Stroke;
Tissue Donors;
Transplants
- From:The Journal of the Korean Society for Transplantation
2010;24(3):159-164
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Due to an impressive reduction in traffic mortalities in recent years, stroke has replaced trauma as the main cause of brain death, and the mean age of donors has increased gradually. As an immediate consequence, donations are growing increasingly more complex and less effective in terms of the number of recipients transplanted, particularly with organs affected negatively by age. The huge regional variability in donation activity observed suggests that there is room for improvement. Generally, liver transplantation extended criteria donors (ECD) are divided by donor-specific characteristics: age >65 years, steatosis >30% of graft volume, long interval between brain death and procurement or graft infected by hepatitis B or C, cold ischemia >12 hours, living donor grafts, split liver grafts, and liver grafts from donors after cardiac death. Deceased donor kidneys are classified as ECD if they meet either of the following conditions: (1) Donor age more than or equal to 60-years or (2) donor age 50 to 59 years, with at least two of the following criteria: serum creatinine more than 1.5 mg/dL, death due to cerebrovascular accident, or history of hypertension. No guidelines exist for allocating an ECD organ. Accurate assessment of the relative risk of graft failure associated with various combinations of donor characteristics is an essential prerequisite for counseling patients, making the decision to accept a transplant offer, evaluating programs, and developing allocation policy.
