Assessment of Deceased Donor Kidneys Using a Donor Scoring System.
10.3349/ymj.2010.51.6.870
- Author:
Kitae BANG
1
;
Han Kyu LEE
;
Wooseong HUH
;
Yu Ji LEE
;
Byun Seung WOON
;
Han RO
;
Young Hwan HWANG
;
Jongwon HA
;
Myoung Hee PARK
;
Sung Joo KIM
;
Su Kil PARK
;
Ha Young OH
;
Jaeseok YANG
;
Curie AHN
Author Information
1. Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Kidney transplantation;
cadaver;
donor selection
- MeSH:
Adolescent;
Adult;
Cadaver;
Death;
Female;
Glomerular Filtration Rate;
Graft Survival;
Humans;
Kidney/*physiology;
Kidney Transplantation/*methods;
Male;
Middle Aged;
Republic of Korea;
Retrospective Studies;
*Tissue Donors
- From:Yonsei Medical Journal
2010;51(6):870-876
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Marginal grafts should be used more actively in Asian countries where deceased donor transplantation is unpopular. We modified a quantitative donor scoring system proposed by Nyberg and his colleagues and developed a donor scoring system in order to assess the quality of deceased donor grafts and their prognostic value as an initial effort to promote usage of marginal donors. MATERIALS AND METHODS: We retrospectively evaluated 337 patients. RESULTS: A scoring system was derived from six donor variables [age, 0-25; renal function, 0-4; history of hypertension, 0-4; Human Leukocyte Antigen (HLA) mismatch, 0-3; body weight, 0-1; cause of death, 0-3 points]. Donor grafts were stratified by scores: grade A, 0-10; grade B, 11-20; grade C, 21-30; and grade D, 31-40 points. Donor grades significantly correlated with estimated glomerular filtration rate (eGFR) at 6 months (A, 64.0 mL/min/1.73 m2; B, 57.0 mL/min/1.73 m2; C, 46.8 mL/min/1.73 m2; p < 0.001). The five-year graft survival rate was also lower in grade C than grade A (74% vs. 93%, p = 0.002). Donors in grade C and D were regarded as marginal donors. The proportion of marginal donors was much lower in Korea, compared with data from the United Network for Organ Sharing (15.2% vs. 29%). CONCLUSION: Considering the scarcity of deceased donor kidneys and the relatively better graft outcome with lower grade-donors in Korea, it is worth increasing the usage of marginal grafts.
