Is acute rejection more frequent in kidney recipients of expanded criteria donors?

Background: Kidney transplantation is the treatment of choice for patients with the end-stage renal disease. Organ shortage is the main barrier to offering this treatment. Using expanded criteria donor's (ECD) organs is one of the strategies to make more transplants available, but may be associated with
additional acute rejection episodes due to stronger antigens expression. Aim:
The aim of this study was to assess the frequency of acute rejection episodes
in recipients receiving a kidney from expanded criteria donor.
Material/Methods: One hundred and seventy two patients received cadaveric
renal transplant between January 1[sup]st[/sup], 2006 and August 31[sup]st[/sup], 2008. Data on donors and recipients was collected. Patient and graft survival as well as acute rejection episodes were analysed. Acute rejection episodes were identified by noting steroid treatment of acute rejection. The follow-up was completed on November 30[sup]th[/sup], 2008. All patients were followed-up for three to thirty five months.
Results: Average 1-year graft survival was 86.9% for the whole group and the mean creatinine concentration was 1.58 ml/dl. One case of primary non-function was observed (0.6%). More than 25% of transplanted kidneys were harvested from ECD. Recipients of ECD kidneys were more likely to have more episodes of acute rejection (57.1% vs. 21.2%, p=0.005).
Conclusions: Recipients of expanded criteria donor kidneys experience more episodes of acute rejection.

Keywords: Kidney Transplantation