S-Space College of Medicine/School of Medicine (의과대학/대학원) Laboratory Medicine (검사의학전공) Journal Papers (저널논문_검사의학전공)
Assessment of Deceased Donor Kidneys Using a Donor Scoring System
- Bang, Kitae; Lee, Han Kyu; Lee, Yu-ji; Huh, Wooseong; Byun, Seung Woon; Hwang, Young-Hwan; Park, Myoung Hee; Park, Su-Kil; Yang, Jaeseok; Ahn, Curie; Oh, Ha-Young; Kim, Sung-Joo; Ha, Jongwon; Ro, Han
- Issue Date
- YONSEI UNIV COLLEGE MEDICINE
- YONSEI MEDICAL JOURNAL; Vol.51 6; 870-876
- Purpose: Marginal grafts should be used more actively in Asian countries where deceased donor transplantation is unpopular. We modified a quantitative donor scoring system proposed by Nyberg and his colleagues and developed a donor scoring system in order to assess the quality of deceased donor grafts and their prognostic value as an initial effort to promote usage of marginal donors. Materials and Methods: We retrospectively evaluated 337 patients. Results: A scoring system was derived from six donor variables [age, 0-25; renal function, 0-4; history of hypertension, 0-4; Human Leukocyte Antigen (HLA) mismatch, 0-3; body weight, 0-1; cause of death, 0-3 points]. Donor grafts were stratified by scores: grade A, 0-10; grade B, 11-20; grade C, 21-30; and grade D, 31-40 points. Donor grades significantly correlated with estimated glomerular filtration rate (eGFR) at 6 months (A, 64.0 mL/min/1.73 m(2); B, 57.0 mL/min/1.73 m(2); C, 46.8 mL/min/1.73 m(2); p < 0.001). The five-year graft survival rate was also lower in grade C than grade A (74% vs. 93%, p = 0.002). Donors in grade C and D were regarded as marginal donors. The proportion of marginal donors was much lower in Korea, compared with data from the United Network for Organ Sharing (15.2% vs. 29%). Conclusion: Considering the scarcity of deceased donor kidneys and the relatively better graft outcome with lower grade-donors in Korea, it is worth increasing the usage of marginal grafts.