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Updated: Feb 1, 2026

Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Marginal kidney transplantation: the road less traveled
Neeraj Sharma1, Arnav Mahajan, Yasir A Qazi
1University of Southern California - Keck School of Medicine, Los Angeles, California, USA.
Purpose Of Review:
Kidney transplantation indisputably confers a significant survival advantage and a better quality of life compared with dialysis, however, because of the increasing demand for kidney transplantation many patients continue to wait prolonged periods for kidney transplantation. The first step to alleviate the shortage is to reduce the discard rate by utilizing more marginal kidneys. This review studied the recent literature on marginal kidney transplantation.
Recent Findings:
More than 60% of high-KDPI kidneys are discarded. Despite the increase in posttransplant costs, use of high KDPI transplants suggests a gain in survival years, thus making marginal kidney transplant cost effective. Furthermore, recent evidence suggests that marginal kidney transplantation shows a survival benefit compared with remaining in the waitlist and minimizes the kidney discard rate.
Summary:
Transplantation with marginal kidneys provides a survival benefit over dialysis or waiting for a low-KDPI kidney. As a result, clinicians should strongly consider transplantation of marginal kidneys as opposed to waiting for a better offer.
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