Complications of transplantation of kidneys from expanded-criteria donors
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Updated: Jun 19, 2026
Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
Published on: May 7, 2019
P Domagala1, A Kwiatkowski, M Wszola
1Department of General Surgery and Transplantology, Medical University of Warsaw, Nowogrodzka 59, 02-006 Warsaw, Poland. pdomagal@mp.pl
Insights
Kidney transplants using expanded-criteria donor (ECD) organs showed similar complication rates compared to standard-criteria donor (SCD) organs. This finding supports maximizing organ use in kidney transplantation.
Area of Science:
- Nephrology
- Transplantation Surgery
- Organ Donation
Background:
- Organ shortage is a critical limitation in kidney transplantation.
- Expanded-criteria donors (ECDs) are increasingly utilized to address organ scarcity.
- ECDs are defined by age (>60 or >50 with risk factors) and specific health indicators.
Purpose of the Study:
- To evaluate and compare post-transplantation complication incidence between ECD and standard-criteria donor (SCD) kidneys.
- To assess the safety and efficacy of utilizing ECDs in renal transplantation.
Main Methods:
- A retrospective analysis of 172 cadaveric renal transplants performed between January 2006 and August 2008.
- Data collection included donor/recipient details, graft function, survival rates, and specific postoperative complications (lymphocele, urinary leak, infection, etc.).
- Follow-up ranged from 3 to 35 months.
Main Results:
- Over 25% of transplanted kidneys originated from ECDs.
- Mean 1-year graft survival was 86.9% with a low primary nonfunction rate (0.6%).
- No significant differences in postoperative complication rates were observed between ECD and SCD kidney recipients.
Conclusions:
- The complication rate following kidney transplantation is comparable whether using organs from expanded-criteria donors or standard-criteria donors.
- This study supports the expanded use of ECDs to mitigate kidney organ shortages without compromising patient safety regarding immediate post-transplant complications.
Background:
Organ shortage is the primary barrier to kidney transplantation. To maximize organ use, organs from expanded-criteria donors (ECDs) have been used increasingly. Expanded-criteria donors are defined as individuals older than 60 years or older than 50 years with at least 2 of the following risk factors: hypertension, stroke as the cause of death, or serum creatinine concentration greater than 1.5 mg/dL.
Objective:
To assess the incidence of complications posttransplantation in ECD kidneys compared with kidneys from standard-criteria cadaveric donors (SCDs).
Patients And Methods:
One hundred seventy-two patients received cadaveric renal transplants between January 1, 2006, and August 31, 2008. Donor and recipient data were collected, as well as patient and graft survival and immediate, delayed, or slow graft function. Complication rates for lymphocele, urinary leak, thrombosis, hematoma, urinary tract infection, and cytomegalovirus infection were recorded. Follow-up was for 3 to 35 months, ending on November 30, 2008.
Results:
Overall, mean 1-year graft survival was 86.9%, and mean creatinine concentration was 1.58 mg/dL. One incidence of primary nonfunction (0.6%) was observed. More than 25% of transplanted kidneys were from ECDs. No significant differences were noted in postoperative complications between recipients of ECD or SCD organs.
Conclusion:
The rate of complications in recipients of ECD and SCD kidneys is comparable.
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