Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression?

Table 1 Expanded criteria donor kidney transplantation: Epidemiological data

Pro	Contra
Annual mortality rate in dialysis patients exceeds 20%[2]	70% increased risk for graft failure vs SCD kidneys[12]
Rapidly growing transplant waiting lists and, subsequently, increasingly longer waiting times[1-3]	17% primary graft non-function vs SCD kidneys[12]
Survival advantage of ECD kidney transplant recipients over dialysis patients remaining on transplant waiting list[2,4,6,15]	38% of ECD kidneys were discarded vs 9% for all other kidneys[12]
	Increased treatment cost and resource use[3,4]
	Mortality in perioperative period greater in ECD kidney recipients[4,13]
	Higher DGF rates, more acute rejection episodes and decreased long-term graft function in ECD vs SCD kidneys[12-14]

ECD: Expanded criteria donor; SCD: Standard criteria donor; DGF: Delayed graft function.