Expanded criteria donors.

These analyses of the UNOS Scientific Renal Transplant Registry data from 1994-1997 showed: 1. There was no significant difference in graft survival between en-bloc and solitary transplants from donors aged 3-4. 2. Double renal allografts should be considered as an alternative to discarding both kidneys when donors are regarded as unsuitable for single kidney transplantation. 3. Prolonged donor HTN had a statistically significant deleterious effect in the multivariate analysis (RR 1.2, p = 0.05 for duration > 10 yrs). 4. A donor history of diabetes, cigarette smoking, or cancer failed to show any significant deleterious effects on graft survival in the multivariate analysis. 5. Matching donors and recipients for HCV genotype may minimize the risk of superinfection when using kidneys from HCV-positive donors (RR 1.4, p = 0.02 for the D+/R- mismatch). 6. Hepatitis B core antibody-positive donors did not pose a significant risk in the multivariate analysis. 7. A high proportion of donors were CMV positive and transplanting kidneys from CMV-positive donors resulted in a significantly but not substantially poorer graft outcome. The highest risk (RR 1.2, p = 0.003) was observed in transplants to CMV-negative recipients. 8. Kidneys from NHBDs who died of trauma survived as well as those from conventional brain-dead donors. NHBDs promise to be an important source for expanding the cadaver donor pool.