Evaluation and Utilization of Expanded Criteria Dornor

Kidney transplantation is the best treatment option for end stage renal disease. As a result of disparity between the demand for kidney transplantation and the supply of suitable organs, kidneys from suboptimal donors have been used in kidney transplantation. Since demonstration of better patient survival, using marginal donor kidney rather than remaining on hemodialysis, more expanded criteria for donor kidneys were adopted in kidney transplantation. Several donor scoring systems, including Nyberg's donor scoring system, donor risk score by Schold, delayed graft function nomogram, kidney donor risk index (KDRI), and histological graft variable have been developed for evaluation of the quality of deceased donor kidneys showing an increased risk for graft dysfunction and loss and for improvement of the stratification; 15% highest risk donors by KDRI and grade C (20∼29 points) and grade D (30∼39 points) by Nyberg's deceased donor scoring system are compatible with the definition of expanded criteria for kidney donors of United Network for Organ Sharing. Utilization of these scoring systems would be very useful in allocation of expanded criteria for donors for improvement of graft and patient survival.