Deceased donor kidney transplant: assessment of eligibility for donor and kidney

Abstract

Kidney transplantation is the optimal treatment for selected patients with end-stage kidney failure. However, the demand for kidney transplantation exceeds the supply of organs available. At the beginning of the twenty-first century, in an attempt to increase the pool of deceased donor organs and reduce organ discard rates, kidney transplant programs have been developed using Expanded Criteria Donor kidneys, for Single or Dual Kidney Transplantation, and kidneys from Donation after Circulatory Death. Moreover, for appropriately selected candidates, are now offered organs from donors with increased but “acceptable” risk profile for the transmission of infectious and neoplastic diseases. Based on this reality, to date, the assessment of eligibility for a deceased donor to kidney transplantation is complex and requires a multidisciplinary approach through each step of the donation process. In this review, we outline the various modalities of kidney transplantation from a deceased donor. We also report the eligibility criteria based on the donor profile for diseases transmissible to the recipient, and the scores based on donor characteristics and histology criteria from kidney biopsies that are currently used to refine the quality of organs used for transplantation.