State of art and innovation in acceptance of expanded criteria donors in kidney transplantation

In the video, Professor Mario Schiffer highlights the current trends in deceased donors, focusing on the risk profile differences between living and deceased donors. Here's a summary of the key points:

Annually, around 21,000 kidney transplants are performed in Europe, and the number of donors who meet the extended criteria is on the rise. Donors who meet the extended criteria include individuals who meet two extra risk factors, such as hypertension, a higher baseline creatinine level, or a cerebrovascular incident, in addition to being over 60 years of age. Furthermore, about 18% of DCD donors may potentially be regarded as extended-criteria donors in that specific scenario.

Knowing that only donors in perfect health are approved means that donations made while the donor is still alive are obviously not actually comparable to donations made after the donor's death. The live donors go through a comprehensive medical examination. Donations from siblings or couples are frequent, which is very helpful as it enables scheduling and reduces the amount of time spent in cold ischemia. While in the case of a deceased donor, the period between the organ's removal and implantation into the recipient's body, as well as the fact that it must typically be carried on ice, greatly increases the risk of delayed graft function or eventual organ failure. Additionally, there is a little data available on the donor's risk profile. Living donation improves transplant survival rates without question.