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Published on: July 15, 2015
Expanded criteria donor kidneys: evolution and current practice
1Department of Transplantation, Sharp Memorial Hospital, San Diego, Calif, USA.
Abstract:
Kidney transplantation is a well-established therapy for chronic renal failure, but its application is limited primarily by the availability of transplantable organs. The number of wait-listed patients continues to grow, and aggressive attempts to increase the numbers of transplants performed have failed to keep pace with demand. The continuing disparity between the demand for kidney transplants and the supply of organs has made efficient use of organs critical, forcing the transplant community to use organs from higher-risk donors than would previously have been considered. The precise definition of some marginal kidneys as expanded criteria donor kidneys was based on objective parameters and intended to expand the donor pool. This article reviews the development and definition of expanded criteria donor kidneys and the current strategies and outcomes associated with their use.
Insights
Kidney transplantation faces organ shortages, driving the use of expanded criteria donor kidneys. This review details their definition, strategies, and outcomes to improve organ utilization.
Area of Science:
- Nephrology
- Transplantation immunology
- Organ donation
Background:
- Kidney transplantation is a vital treatment for end-stage renal disease.
- Organ scarcity limits transplantation, with demand exceeding supply.
- Higher-risk donors are increasingly considered to meet demand.
Purpose of the Study:
- To review the evolution and definition of expanded criteria donor (ECD) kidneys.
- To outline current strategies for utilizing ECD kidneys.
- To assess the outcomes associated with ECD kidney transplantation.
Main Methods:
- Review of historical development and objective parameters for defining ECD kidneys.
- Analysis of current transplant strategies involving ECD organs.
- Evaluation of clinical outcomes and graft survival rates.
Main Results:
- ECD kidney definition aims to expand the donor pool.
- Objective parameters guide the identification of suitable ECD kidneys.
- Strategies are evolving to optimize the use of ECD organs.
Conclusions:
- Efficient organ utilization is critical due to transplant demand.
- ECD kidneys represent a strategy to increase organ availability.
- Further research and optimized strategies are needed for ECD kidney transplantation.
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