Effects of the clinical characteristics of the organ donor on the long-term results of the transplant and survival of the patient, with particular reference to kidney transplants

Introduction

To assess the role of the single clinical parameters of the donor on the outcome of the transplant and the variability of this in relation to the state of an optimal or borderline donor.

Methods

One hundred and fifty-one receiving and deceased donor brace subordinates to kidney transplant. Clinical parameters investigated for every donor were: age, arterial hypertension (≥140/80 mmHg), diabetes, blood values of creatinine. It was chosen to classify as marginal all the donors with age >55 years, and/or hypertension, and/or diabetes, and/or with blood values of creatinine >1.5 mg/dl, and/or whose death has happened because of one whichever pathology that has determined cerebral anoxia. Based on such parameters the donors' borderline was 72/151 (47.7%), while the optimal was 79/151 (52.3%). The mean age of the donors was 47.5 years (range 14–81 years). The population of the 151 receiving optimal and marginal kidneys was constituted of patients judged suitable for the transplant with typical risk factors for a standard population of subjects on dialysis. The mean age of receiving patients was 46 years (range 21–71 years). We have classified receiving based on the outcome of the transplant to 5 years, as: patients alive with transplanted kidney still working, deceased patients, and patients re-entered to haemodialysis.

Results

Eighty-seven per cent (n = 69) of kidneys transplanted from optimal donors, in fact, have turned out working, 4% (n = 3) have re-entered haemodialysis within 5 years from the surgery, and only 9% (n = 7) have deceased in the same period. Regarding marginal kidney receiving, it has been possible to demonstrate that 72% (n = 52) of such subjects maintained a good function of the transplant, 11% (n = 8) re-entered haemodialysis, and 17% passed away within 5 years of the transplant.

Conclusion

The difference between the survival of the two receiving groups is not such to justify the exclusion of marginal donors from the 'pool' of potential kidney donors. Considering that, the use of marginal donors can be a valid system in order to supply the lack of organs. Moreover the histological examinations, executed on patterns captured with wedge biopsy before the transplant, can be an effective strategy finalized for the expansion of potential kidney donors.