Kidney Transplantation from Expanded Criteria Donor in Korea: It's Time to Have Our Own Criteria Based on Our Experiences

Abstract

The disparity between the number of patients awaiting kidney transplantation (KT) on the list and the number of actual number of KT from deceased organ donation has become wider despite the recent increase in the number of donations. Moreover, the proportion of donors aged 60 or more has rapidly increased. KT from expanded criteria donor (ECD) has been not only been necessary, but also inevitable with respect to maximizing the use of this scarce organ resource. However, we still use the "marginal donor criteria" implemented in 2000 when KONOS (Korean Network for Organ Sharing) was established. In the Korean transplantation environment, this "marginal donor criteria" does not have the power to predict graft outcome, and fails to discern grafts with inferior transplant outcomes from successful transplants. As a result, it does not meet the role of the criteria in Korea.Therefore, we should develop our own criteria based on our deceased donor kidney transplantation experience. Here, we review the current status of ECD KT in Korea in context with the progression of the ECD criteria system in UNOS (United Network for Organ Sharing) and present some considerations for the Korean donor criteria system.

Clinical outcomes of the first 300 cases of kidney transplantation: a single-center retrospective cohort study

“…Living donor transplantation contributes to the majority of the increase, since organ shortage is still a major issue [ 1 ]. Recent reports have been focused on increasing the donor pool by expanding the indication for kidney donation by means of ABOi transplantation and ECD and DCD transplantation [ 3 - 7 ]. Although our experience is limited for ECD and DCD transplantation, many cases of LDKT and ABOi kidney transplantation have been performed in SNUBH up to date.…”

“…Despite the increase of transplant cases, the number of patients on Clinical outcomes of the first 300 cases of kidney transplantation: a single-center retrospective cohort study www.ekjt.org Koh HW et al Clinical outcomes of the first 300 cases of KT the waiting list is increasing more rapidly each year due to the increased prevalence of chronic kidney disease [1,2]. Approaches to increase potential donor groups such as ABO-incompatible (ABOi) donors [3], extended criteria donors (ECD) [4], and donation after cardiac death (DCD) [5,6] are being implemented to overcome the organ shortage problem. Outcomes of these approaches have been shown to be acceptable compared to donation after brain death (DBD) and are superior to waiting for a DBD kidney [7].…”