[22] mL /min/1.73 [m.sup.2] at 12 months was 56.0 (42.6-67.9) & at 24 months 53.4 (46.4-66.4) ml/minute * .[MMF.sup.*] (mycophenolate mofetil), [AZA.sup.*] (azathioprine), [IL-2.sup.*] (interleukin-2), [ECD.sup.*] (
extended Criteria Donor), e [GFR.sup.*] (estimated glomerulofilteration rate), [ATG.sup.*] (antithymocyte globulin), and [SCD.sup.*] (standard criteria donor), [OKT3.sup.*] (muromonab-CD3).
These
extended criteria donors (ECD) can be separated into two broad categories: those associated with risk for poor function based on physiologic stress or liver injury in the donor, and those with the risk of disease transmission (viral or malignancy) from donor to recipient11.
The patients who received
extended criteria donor (ECD) kidneys had a mean age of nearly 69 years, whereas their donors died at a mean age of almost 67 years.
The global escalating shortage of organ donors has driven centres to use
extended criteria donors (ECD), including elderly people, steatotic liver, and donation after cardiac death (DCD), as well as recently using donors that are actively infected with hepatitis C virus.
When stratified by the recipient risk scores, the posttransplantation outcomes appear profoundly worse in transplantation of
extended criteria donors to high-risk recipients.
The discrepancy between the donor supply and demand has led to an increased use of organs from
extended criteria donors and donation after cardiac death donors, as an attempt to close the gap.
This trend can be explained by multiple or repeating offers of marginal organs from
extended criteria donors to different transplant centers and may be attributed to a more restrictive policy for acceptance of organs from
extended criteria donors for high-MELD patients, which are prioritized in the Eurotransplant allocation system.
Recommendations for the use of
extended criteria donors in lung transplantation.
After the implementation of MELD, rating patients with a higher score based on longer waiting times became meaningless, and acceptance of an organ from
extended criteria donors via centre-based allocation represents the only opportunity for transplantation.
Despite increasing acceptance of marginal or
extended criteria donors, the increase in potential transplant recipients has not been met by increases in the numbers of medically suitable brain-dead potential organ donors.
Extended criteria donors in liver transplantation: adapting donor quality and recipient.
The cost implications of using more
extended criteria donors and donation after cardiovascular death should also be objectively explored.