[Marginal donor and high risk recipient in kidney transplantation]

With the current shortage of solid organs for transplant, the transplant community continues to look for ways to increase the number of organ donors, including marginal donors. In Japan, deceased organ donation is limited and ABO-incompatible kidney transplantation has flourished since the 1990's. Recently, older donors have been increasing in kidney transplantation. There has also been an increase of older recipients and high-risk recipients such as highly sensitized recipient is recognized. We review the evaluation and management for the marginal donor and high-risk recipient.