Current trends in acceptance of expanded criteria donors in kidney transplantation

In the video, Professor Mario Schiffer highlights several key aspects of the current trends in deceased donors, specifically focusing on age, comorbidities, and the expanded criteria for donation. Here's a summary of the key points:

Age of Donors: The current trend indicates that kidney transplantation programs are increasingly open to accepting organs from older donors. The recent advancements in transplantation techniques and immunosuppressive therapies have made it possible to utilize kidneys from older individuals effectively.

Comorbidities: There is a noticeable increase in deceased donors with comorbidities such as hypertensive disease or diabetes.  This shift is based on the understanding that well-maintained organs from donors with controlled comorbidities can still be viable for transplantation.

Non-standard Risk Factor Donors: The expanded criteria for donation now encompass a broader range of potential donors. This includes individuals with unusual organ anatomy, whose blood vessel systems may not be typical. Additionally, donors with infectious diseases like HIV or HCV are considered for recipients who are also HIV positive, expanding the donor pool further.

Now, let's consider how this trend affects the risk profile of kidney transplantation:

Controlled Diseases: When diseases like hypertension or diabetes are well-controlled in extended criteria donors, the functionality of the transplanted kidney is not significantly affected. With proper management and post-transplant care, recipients can have successful outcomes.

Donors with Hypertension or Diabetes: However, in cases where extended criteria donors have a history of hypertension or diabetes, the outcome of the transplant may be impacted. Recipients should be carefully selected, and post-transplant care should be tailored to manage potential complications associated with these comorbidities.