Is estimated donor glomerular filtration rate before death a better predictor of decreased-donor kidney function?

The worldwide shortage of deceased-donor kidneys for transplantation has become a serious issue in the past decade, leading to study of marginal donors. However, both the availability and the utility of kidneys from deceased donors are still unclear. The aim of the present study was to evaluate another method to estimate donor kidney function rather than using donor creatinine (Cr). We studied 129 recipients of deceased-donor kidneys from Maastriche donor categories III and IV. We analyzed donor Cr levels before death and recipient Cr levels at 1 year after transplant, as well as estimated glomerular filtration rates (eGFR). There was no significant difference in donor Cr levels at admission to the hospital and before death according to eGFR at 1 year after transplantation: <30 mL/min/1.73 m(2) versus ≧30 mL/min/1.73 m(2). However, recipients whose donors showed lower average eGFR levels on admission displayed better renal function at 1 year after transplant (P = .025). In conclusion, donor Cr levels before death was a less useful measurement to relate to recipient renal function; eGFR provided a better index.