[Comparison of functional and morphological changes of transplanted kidneys from marginal and ideal donors]

Despite an increased number of cadaver donors and organ transplantations, there is a marked increase in the number of patients included in the transplantation waiting list.

The aim of the study was to evaluate functional and morphologic changes of kidney allografts obtained from marginal (n = 63) and "ideal" donors (n = 186). In patients with kidneys from marginal donors, the impact of donor age and the presence of hypertension in donors on kidney function were also studied.

One year after kidney transplantation, kidney function was similar in patients transplanted with kidneys from marginal and "ideal" donors, although significant morphologic differences were observed between the two groups. However, five years after transplantation serum creatinine (p = 0.0001) and eGFR (p = 0.003) were significantly different between patients transplanted with kidneys from marginal and "ideal" donors. There was also a significant difference in serum creatinine level of patients who received kidneys from donors older than 55 years of age compared to patients whose kidney allografts were obtained form donor who has hypertension (p = 0.0003). Acute rejection episodes (p = 0.0004) and interstitial fibrosis/tubular atrophy (p = 0.002) occurred more frequently in patients with kidneys from marginal compared to those from "ideal" donors.

One year after kidney transplantation renal function is similar in patients transplanted with kidneys from marginal and "ideal" donors, but patients with kidneys from marginal donors have significantly more impaired renal function five years after kidney transplantation.