Abstract
Increasing disparity between the limited supply of deceased donor organs and the rising demand for kidneys has led to considering alternative strategies for expanding the availability of organs for transplantation. The first definition of expanded criteria donor contained four different donor risk factors for graft failure: age, history of hypertension, cerebrovascular accident as a cause of death and final pre-procurement creatinine > 133mmol/l. Marginal donors are also those with diabetes or those with anatomical abnormalities. Other factors such as donor maintenance, surgeon related factors, perfusion and transportation of organs also have an influence on donor organ quality. The survival benefits seen in recipients of marginal kidney transplants are inferior compared to those in recipients of standard criteria donor kidneys, but significantly better than in those remaining on kidney waiting list.
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