Kidney transplantation from marginal donors: results and allocation strategies

Abstract

We evaluated our results of kidney transplantation from marginal donors who had dopamine-dependent unstable haemodynamics and died from traumatic or haemorrhagic shock. The control group I of 723 patients (with kidney transplanted from donors who died from craniocerebral injury) was compared to group II of 41 patient with kidneys transplanted from the marginal donors. The followed up period was 52 ± 19 months. In both groups the percent of dilate graft function, primary non function transplants, acute graft rejection, patients and graft survival, biopsy prove ischemic-reperfusion graft injury were evaluated. In group II the percent of dilate graft function, primary non function transplants was higher (67% and 51%, 7 and 4%, respectively). 5-years grafts and patients survival rates in group II were lower than in group I (67 and 73%, 71 and 78%, respectively, р < 0,05). At the end of the follow up period the level of serum creatinine was 151 ± 50 mM in group I and 165 ± 80 mM in group II. We conclude that despite slightly worse results in group II, kidney transplantation from marginal donors can be used to decrease the transplant waiting time.