Abstract

MANY CENTERS HAVE BEEN reluctant until now to perform kidney transplantation (KT) with organs coming from living donors (LDs), whose grafts show multiple arteries or vascular disease, due to the more frequent surgical complications and lower graft survival. Moreover, an ethical dilemma arises with respect to the age of the living donor: the aging donor is considered to be at greater operative risk and their grafts inferior to those from younger donors. However, the critical shortage of organs continues to represent the main limitation for diffusion of KT forcing the use of these living donor “marginal” kidneys. The aim of this paper was to evaluate the outcomes of 285 KTs using LDs, 33 having multiple arteries and 39 from patients over 60 years of age at nephrectomy. The results of these marginal kidneys, with particular regard to those performed during CsA era, are compared with the outcome of LD grafts with normal arterial supply or coming from younger LDs.

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