Filiopoulos V, Boletis JN. Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression? World J Transplant 2016; 6(1): 103-114 [PMID: 27011908 DOI: 10.5500/wjt.v6.i1.103]
Corresponding Author of This Article
Vassilis Filiopoulos, MD, Department of Nephrology and Transplantation Unit, Laiko University Hospital, 17 Agiou Thoma Street, 11527 Athens, Greece. vassilis.filiopoulos@hotmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Mar 24, 2016; 6(1): 103-114 Published online Mar 24, 2016. doi: 10.5500/wjt.v6.i1.103
Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression?
Vassilis Filiopoulos, John N Boletis
Vassilis Filiopoulos, John N Boletis, Department of Nephrology and Transplantation Unit, Laiko University Hospital, 11527 Athens, Greece
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Vassilis Filiopoulos, MD, Department of Nephrology and Transplantation Unit, Laiko University Hospital, 17 Agiou Thoma Street, 11527 Athens, Greece. vassilis.filiopoulos@hotmail.com
Telephone: +30-210-7456351 Fax: +30-213-2061243
Received: August 6, 2015 Peer-review started: August 7, 2015 First decision: October 16, 2015 Revised: December 17, 2015 Accepted: December 29, 2015 Article in press: January 4, 2016 Published online: March 24, 2016
Core Tip
Core tip: Kidney donor shortage is chronic, persistent and increasing in most countries worldwide. Therefore, there has been renewed interest in the use of expanded criteria donors (ECD) to increase donor pool. Compared to standard criteria donor kidneys, ECD kidneys are associated with up to a two-fold increased risk of delayed graft function, acute rejection, and graft loss. The optimal induction and maintenance immunosuppressive regimen for ECD transplant recipients is not known due to shortage of randomized trials. Induction with antithymocyte globulin and maintenance with calcineurin inhibitors-sparing regimens have been advocated, especially for older recipients of ECD kidneys. This review provides insights into topics such as selection of appropriate candidates for kidney transplantation from ECDs, optimal management of ECD transplant recipients and discusses literature data on the immunosuppressive regimens that have been used in this patient population.
