Utilization of Kidneys With Similar Kidney Donor Risk Index Values From Standard Versus Expanded Criteria Donors

  1. K. J. Woodside1,*,
  2. R. M. Merion2,3,
  3. A. B. Leichtman3,4,
  4. R. de los Santos3,
  5. C. J. Arrington3,
  6. P. S. Rao3,4,
  7. R. S. Sung2,3

Article first published online: 15 JUN 2012

DOI: 10.1111/j.1600-6143.2012.04146.x

Issue

American Journal of Transplantation

American Journal of Transplantation

Volume 12, Issue 8, pages 2106–2114, August 2012

Additional Information

How to Cite

Woodside, K. J., Merion, R. M., Leichtman, A. B., Santos, R. d. l., Arrington, C. J., Rao, P. S. and Sung, R. S. (2012), Utilization of Kidneys With Similar Kidney Donor Risk Index Values From Standard Versus Expanded Criteria Donors. American Journal of Transplantation, 12: 2106–2114. doi: 10.1111/j.1600-6143.2012.04146.x

Author Information

  1. 1

    Department of Surgery, Case Western Reserve University, Cleveland, OH

  2. 2

    Department of Surgery, University of Michigan, Ann Arbor, MI

  3. 3

    Arbor Research Collaborative for Health, Ann Arbor, MI

  4. 4

    Department of Internal Medicine, University of Michigan, Ann Arbor, MI

* Kenneth J. Woodside, kenneth.woodside@uhhospitals.org

Publication History

  1. Issue published online: 27 JUL 2012
  2. Article first published online: 15 JUN 2012
  3. Received 31 January 2012, revised 16 March 2012 and accepted for publication 10 April 2012

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Keywords:

  • Expanded criteria donor (ECD);
  • kidney donor risk index (KDRI);
  • kidney transplantation;
  • outcomes;
  • registry;
  • utilization

With the shortage of standard criteria donor (SCD) kidneys, efficient expanded criteria donor (ECD) kidney utilization has become more vital. We investigated the effects of the ECD label on kidney recovery, utilization and outcomes. Using data from the Scientific Registry of Transplant Recipients from November 2002 to May 2010, we determined recovery and transplant rates, and modeled discard risk, for kidneys within a range of kidney donor risk index (KDRI) 1.4–2.1 that included both SCD and ECD kidneys. To further compare similar quality kidneys, these kidneys were again divided into three KDRI intervals. Overall, ECD kidneys had higher recovery rates, but lower transplant rates. However, within each KDRI interval, SCD and ECD kidneys were transplanted at similar rates. Overall, there was increased risk for discard for biopsied kidneys. SCD kidneys in the lower two KDRI intervals had the highest risk of discard if biopsied. Pumped kidneys had a lower risk of discard, which was modulated by KDRI for SCD kidneys but not ECD kidneys. Although overall ECD graft survival was worse than SCD, there were no differences within individual KDRI intervals. Thus, ECD designation adversely affects neither utilization nor outcomes beyond that predicted by KDRI.

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