Use of Cadaveri̇c Margi̇nal Donors in Kidney Transplantation: a Single Center Experience

Use of Cadaveri̇c Margi̇nal Donors in Kidney Transplantation: a Single Center Experience | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Use of Cadaveri̇c Margi̇nal Donors in Kidney Transplantation: a Single Center Experience Yavuz AYAR, Alparslan Ersoy, Emel Isıktas Sayilar, Abdulmecit Yildiz, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4518032/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: The increase in the need for organs and decrease in the cadaver pool have led to a tendency towards organ transplantation from marginal donors. In our study, patients who underwent transplantation based on the standard and expanded donor criteria were compared in terms of factors affecting graft survival. Methods: Data of patients who underwent transplantation from cadavers with standard and extended criteria (SCD, ECD) between 01.07.2011 and 30.06.2016 evaluated retrospectively. Donor characteristics, treatment type, response and graft characteristics, 1st, 3rd and 5th year graft survival, and acute rejection rates were analyzed, retrospectively. Results : The causes of death, cerebrovascular accidents were more common in the ECD group (p<0.001). Hypertension and diabetes were more common in both donor groups and detected more frequently in recipients in the ECD group (p<0.001). The absence of mycophenolate mofetil (MMF) use and the presence of an acute rejection attack adversely affected graft survival at the end of the 1st, 3rd and 5th years. Conclusion: The use of marginal donors is widespread. Appropriate monitoring of patients undergoing immunosuppressive therapy, especially using MMF and the presence of acute rejection, affects graft survival. Therefore, attention should be paid to immunosuppressive treatment and rejection in ECD transplant recipients. Acute rejection cadaveric transplantation marginal donor mycophenolate mofetil Figures Figure 1 Figure 2 Figure 3 INTRODUCTION The incidence of CKD also increases with an increase in comorbid diseases (such as hypertension and diabetes), and kidney transplantation remains the priority for patient survival as renal replacement therapy (RRT) in CKD. In previous studies, survival after transplantation from a suitable cadaver seems to be superior to that of other RRT (1-3). In recent years, the difficulties in finding donors and the decrease in the cadaver pool have increased the waiting time for dialysis and the interest in using marginal donors. In the USA, before 2001, the rate of cadaveric age ≥ 60 years was 50%. The rate of cadavers over 60 years of age in France was 26.8% in 2005. In 2002, The Organ Procurement and Transplantation Network (OPTN) defined marginal donors and expanded donor criteria (ECD). ECD was defined as older kidney donors (> or =60 yr) or donors who are aged 50 to 59 year and have two of the following three features: Hypertension, terminal serum creatinine >1.5 mg/dl, or death from cerebrovascular accident. (2-7). Scoring systems such as the kidney donor profile index (KDPI) and kidney donor risk index (KDRI) are used to asses cadaver quality (8, 9). In our study, we retrospectively evaluated graft and patient survival and outcomes of cadaveric kidney transplantation according to the ECD and standard donor criteria (SCD) in our unit. METHODS Patients The data, donor characteristics, recipient treatments, graft characteristics, and clinical and laboratory values of patients who underwent transplantation in our center between 01.07.2011 and 30.06.2016 using ECD (63 patients) and SCD (92 patients) were compared randomly and retrospectively from hospital records. ECD describes as older kidney donors (> or =60 yr) or donors who are aged 50 to 59 year and have two of the following three features: Hypertension, terminal serum creatinine >1.5 mg/dl, or death from cerebrovascular accident. The Kidney Donor Risk Index (KDRI) score was calculated by evaluating data on age, weight, height, race, creatinine, blood pressure, diabetes, and hepatitis C history. KDRI values were converted to KDPI values using Organ Procurement and Transplantation Network (OPTN) data (10). In our study, CNI-based regimens [Kidney Disease: Improving Global Outcomes (KDIGO transplantation guidelines)] were mostly used. As recommended by the guidelines, the cyclosporine level was tried to be kept around 200 ng/mL in the first 3 months, 150-200 ng/mL in the next 6 months, then 100-150ng/mL until the 2nd year, and 100 ng/mL after the 2nd year. The tacrolimus level was tried to be kept in the range of 12-15 ng/mL for the first 3 months, then 10-12 ng/mL for the first 6 months, then 8-10 ng/mL until the 2nd year, and 5.2-8 ng/mL after the 2nd year. The dose of mycophenolate mofetil was tried to be given as full as possible (2000 mg/day for mycophenolate mofetil, 1440 mg/day for mycophenolate sodium). The dose was reduced in patients with diarrhea, severe infection, risk of sepsis, thrombocytopenia, severe leukopenia, etc. (According to the Elite-Symphony Trial). The corticosteroid dose (prednisolone) was reduced to 5 mg/day after 6 months. Switching to mTOR was performed in patients who developed calcineurin toxicity (nephrotoxicity) (11). Donors who did not meet the condition of being cadavers, such as those with a history of cancer, high risk of transmission, and active infection, were excluded from the study. Patients who did not have regular follow-ups during the specified period and were transferred to another center were also excluded from the study. We de-identified all patient details (12). Ethics committee approval was obtained with the decision dated 15.01.2019-2019-1/21 at the outer center. We allow that fellow researchers may reproduce our methodology. Our study was retrospective and permissions obtained from the ethics committee to share visual data and patient information. Biostatistical analysis Data are expressed as mean ± SD and median (min-max). Percentage change values were calculated as (postoperative value-preop value)/preoperative value for time-dependent values and used in intergroup comparisons. Mann-Whitney U test, independent sample t-test, Pearson chi-square test, Fisher exact test, and Fisher Freeman Halton test were used for comparisons. Survival times were calculated using Kaplan-Meier analysis, and factors were examined using the log-rank test. Cox regression analysis was used to determine the hazard ratios and risk factors. Statistical analyses were performed usingStatistical Package for Social Sciences for Windows [version 22.0; (SPSS, Chicago, IL, USA)]. Statistical significance was set at p< 0.05. RESULTS As expected the mean age of the SCD group was lower than that of the ECD group. The last and 24-hour urine volume were lower in the ECD group. Body mass index (BMI) was higher in the ECD group. The number of cadavers with a history of diabetes and hypertension was higher in the ECD group. Additionally, the cause of death due to trauma was more prominent in the SCD group. The cold ischemia time was longer in patients with ECD. The rates of HT and DM in recipients and the KDPI and KDRI scores were higher in the ECD group. When the recipients were evaluated, the history of HT was higher in transplant recipients from the ECD group. In terms of hospitalization due to infection, acute rejection, and graft and patient survival after transplantation, there was no change in the recipients according to the type of cadaver (Tables 1and 2). The incidence of primary non-functioning kidneys was higher in the ECD group. The firstmonth creatinine level was higher and the GFR level was lower in the ECD group (Table 3). No difference was observed between the two groups in terms of the surgical and medical complications observed after transplantation (Tables 4 and 5). According to the 1, 3 and 5 year survival results (for graft), renal survival was longer in mycophenolate mofetil (MMF) users, and renal survival was adversely affected in patients with acute rejection (Figure 1-3). When patient survival time was examined for 1, 3 and 5 year survival for patients, it was not statistically significant. No significant results were found in the multivariate analysis. DISCUSSION The need for renal replacement therapy has increased owing to an increase in the incidence and prevalence of chronic kidney diseases. In kidney transplantation, the need to find donors and cadavers and the length of stay of patients on dialysis have increased. Paired kidney exchange, dual kidney transplantation, and marginal donor use are used to meet patient needs. Considering the global increase in the elderly population, an increase in marginal donor use is expected in the future. In our country's database, the donor rate between the ages of 45-64 was 36.05%, which was 5.36% over the age of 65 years. These rates increased compared to those in the previous year (29.72% and 4.04, respectively) (9, 13). The use of marginal donors affects both patient and graft survival (14). In transplants from elderly patients (> 60 years), graft and patient loss were higher at the end of the 1st and 5th years compared to those transplanted with standard criteria. In a study that evalueted, 1554 recipients from Switzerland, patient and graft survival were negatively affected when donor age increased (15, 16). As expected, in our study, age was higher in the ECD group than the SCD group. The incidence of rejection and primary nonfunctional grafts increased after the use of marginal donors. The incidence of a primary non-functioning kidney was approximayely 2% in patients with a KDPI ≥80. The rejection rate was 7% by the end of the 6th month. In a study in which 720 cadaveric donors were evaluated, acute rejection rates were higher in patients with a KDPI>85. In this study, the contribution of acute rejection rate to graft function at the end of the first year was not significant. In another study, 663 transplants analyzed and age-related acute rejections after three months had a negative effect on graft survival at the end of the 1st and 5th years. In addition, rejection rates were similar between the SCD and ECD groups in some studies. Acute rejection rates are high in patients with delayed graft (DGF) function (9, 17-20). In our study, no change was detected in the rejection rates in either group. In the regression analysis, the 1st, 3rd and 5th year graft survivals were poor in those who had an acute rejection attack. Rejection is thought to affect graft survival due to the effects of the primary disease and immunosuppressive therapies. Drug pharmacokinetics in elderly patients should also be considered, particulary with regard to the effectiveness of immunosuppressive therapies. Considering the patient's clinical and side-effect profiles in terms of immunosuppressive therapies, it was determined that the pharmacokinetics of calcineurin inhibitors (CNI) and steroids changed, but MMF did not (21). However, CNI-free regimens based on reduced CNI exposure and mammalian target of rapamycin inhibitors (mTOR inhs) have shown acceptable results in appropriately selected ECD transplant recipients. CNI-free mTOR inhs -based therapy compared with MMF-based treatment in kidney transplantation with advanced-age donors was associated with an acceptable outcome, but increased proteinuria and acute rejection in mTOR inhs -treated patients was more detected. The best results with mTOR inhs have been found in patients without delayed graft function (22). In a multicenter study including 3143 patients, the combination of CNI and MMF increased graft survival and decreased acute rejection rates (23). Studies have shown that MMF plays a key role in immunosuppressive treatment regimens, and rejection and graft survival are adversely affected by dose reduction and discontinuation of the drug (24). In our study, MMF had a positive effect on 1st, 3rd and 5th year graft survival. The most important shortcomings of our study are that it was retrospective, the number of patients was small, and HLA and donor-specific antibodies could not be tested. In conclusion, acute rejection attacks negatively affect graft survival and MMF plays an important role in the RRT treatment protocol. Therefore, attention should be paid to immunosuppressive treatment and rejection in ECD transplant recipients. Therefore, dose and drug changes should be closely monitored. Declarations ACKNOWLEDGEMENT Author Contributions Writing, preparation: YA, AE, and EIS. Statistical analysis: FEC. Data Collecting: YA and; EIS. Pre-Evaluation: YA, AE, AY, and AO. Conflict of interest None Funding Statement None Data Availability Data and information about the article can be used with the permission of the journal publisher and the corresponding author. References Collins AJ, Foley RN, Gilbertson DT, Chen SC, United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl (2011) 2015;5(1):2-7. Noble J, Jouve T, Malvezzi P, Süsal C, Rostaing L. Transplantation of Marginal Organs: Immunological Aspects and Therapeutic Perspectives in Kidney Transplantation. Front Immunol. 2020;10:3142. Filiopoulos V, Boletis JN. Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression? World J Transplant. 2016;6(1):103-14. Wang Z, Durai P, Tiong HY. Expanded criteria donors in deceased donor kidney transplantation - An Asian perspective. Indian J Urol. 2020;36(2):89-94. Audard V, Matignon M, Dahan K, Lang P, Grimbert P. 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Nephrol Dial Transplant. 2007;22(8):2316-21. Knight SR, Russell NK, Barcena L, Morris PJ. Mycophenolate mofetil decreases acute rejection and may improve graft survival in renal transplant recipients when compared with azathioprine: a systematic review. Transplantation 2009;87(6):785-94. Su VCh, Greanya ED, Ensom MH. Impact of Mycophenolate Mofetil Dose Reduction on Allograft Outcomes in Kidney Transplant Recipients on Tacrolimus-Based Regimens: A Systematic Review. Ann Pharmacother. 2011;45(2):248-57. Tables Table 1. Comparisons about donor type Donor Type SCD (n=92) ECD (n=63) p Gender (n,%) Male 63 (68.50%) 38 (60.30%) 0.381 Female 29 (31.50%) 25 (39.70%) Age (n) 41 (20-59) 62 (42-86) p<0.001 Donor height (cm) 170 (150-196) 170 (150-185) 0.133 Donor kg 70 (50-115) 75 (52-115) 0.065 The last urine (cc) 180 (10-1000) 100 (20-1400) 0.023 24-hour urine (cc) 4255 (750-14950) 3200 (800-7500) 0.030 Donor BMI 24.71±3.24 26.96±3.64 p<0.001 DM in donor (n,%) Yes 0 (0%) 27 (42.90%) p<0.001 No 92 (100%) 36 (57.10%) HT in donor (n,%) Yes 8 (8.70%) 59 (93.70%) p<0.001 No 84 (91.30%) 4 (6.30%) Cause of death (n,%) CVA 62 (67.40%) 60 (95.20%) p<0.001 Trauma 24 (26.10%) 1 (1.60%) Other 6 (6.50%) 2 (3.20%) İntensive Care Hospitalization (day) 3 (1-21) 3 (1-10) 0.134 Cold ischemia (hour) 10 (1-21) 12 (4-36) 0.020 HbsAg (n,%) Pozitive 2 (2.20%) 3 (4.80%) 0.397 Negative 90 (97.80%) 60 (95.20%) antiHbs (n,%) Pozitive 39 (42.40%) 53 (57.60%) 0.241 Negative 20 (31.70%) 43 (68.30%) Yes 8 (8.70%) 59 (93.70%) p<0.001 No 84 (91.30%) 4 (6.30%) KDPI (%) 56 (19-88) 97 (65-100) <0.001 KDRI (%) 1.06 (0.73-1.57) 1.93 (1.16-3.50) <0.001 HLA missmatch (n) 2 (1-6) 2 (1-6) 0.865 DM: Diabetes Mellitus. BMI: Boddy mass index. CVA: Cerebrovascular accident. HT: Hypertension. HbsAg: Hepatitis B surface antigen. antiHbs: Hepatitis B surface antibody. KDPI: Kidney donor profile index. KDRI: Kidney donor resistive index. CMV: Cytomegalovirus. Table 2. Characteristics of recipients Recipient Age (n) SCD (n= 92) 42.50±13.27 ECD (n=63) 42.84±14.34 0.879 HT in recipient (n, %) Yes 0 (0%) 27 (42.90%) p<0.001 No 92 (100%) 36 (57.10%) DM in recipient (n, %) Yes 19 (20.70%) 16 (25.40%) 0.618 No 73 (79.30%) 47 (74.60%) Hospitalization after Tx (n, %) UTI 20 (21.70%) 16 (25.40%) 0.926 Pneumonia 25 (27.20%) 15 (23.80%) Surgical complication 11 (12%) 9 (14.30%) Rejection 8 (8.70%) 6 (9.50%) Other 8 (8.70%) 3 (4.80%) None 20 (21.70%) 14 (22.20%) Graft loss (n,%) Yes 12 (13%) 10 (16.10%) 0.763 No 80 (87%) 52 (83.90%) Mortality Alive 76 (82.60%) 48 (76.20%) 0.162 Rejection 5 (5.40%) 9 (14.30%) Exitus 11 (12%) 6 (9.50%) DM: Diabetes Mellitus. HT: Hypertension. Tx: Transplantation. UTI: Urinary tract infection. Table 3. Comparisons about primer treatments SCD (n=92) ECD (n=63) p CNI (n,%) Cyclosporine 49 (53.30%) 26 (41.30%) 0.142 Tacrolimus 43 (46.70%) 37 (58.70%) MMF (n,%) Yes 84 (91.30%) 55 (87.30%) 0.592 No 8 (8.70%) 8 (12.70%) mTOR (n,%) Yes 6 (6.50%) 6 (9.50%) 0.549 No 86 (93.50) 57 (90.50%) Primary non-functioning kidney (n,%) Yes 0 (0%) 5 (7.90%) 0.010 No 92 (100%) 58 (92.10%) Acute Rejection (n,%) Yes 19 (20.70%) 15 (23.80%) 0.788 No 73 (79.30%) 48 (76.20%) DGF (n,%) Yes 13 (14.10%) 14 (22.20%) 0.276 No 79 (85.90%) 49 (77.80%) ATN (n,%) Yes 31 (33.70%) 20 (31.70%) 0.936 No 61 (66.30%) 43 (68.30%) CNI: Calcineurin inhibitors. MMF: Mycophenolate mofetil. mTOR: The mammalian target of rapamycin. DGF: Delayed graft function. ATN: Acute tubular necrosis. Table 4. Comparisons about serum creatinine and GFR SCD (n=92) ECD (n=63) p Serum creatinine first month (mg/dL) 1.30 (0.53-8.90) 1.61 (0.46-14.80) 0.014 Serum creatinine sixth month* 0.08 (-1:1.28) -0.03 (-0.84:1.15) 0.061 Serum creatinine twelfth month* -0.02 (-1:3.24) 0.01 (-0.85:5.96) 0.208 Serum creatinine final* -0.04 (-1:9.34) 0 (-0.82:6.01) 0.510 GFR first month (ml/min/m 2 ) 57.67 (7-202) 44 (3.57-202) 0.005 GFR sixth month* -0.07 (-1:65.26) 0.04 (-0.59:4.13) 0.010 GFR twelfth month* -0.05 (-1:7.18) -0.07 (-0.90:5.66) 0.572 GFR final* -0.07 (-1:6.73) -0 (-0.90:4.77) 0.445 * Percentage change values was calculated and compared. GFR: Glomerular filtration rate. Table 5. Post-transplant surgical and medical complications SCD (n=92) ECD (n=63) Serum urea (mg/dL) 42 (6-114) 57 (15-137) Serum creatinine (mg/dL) 1.10 (0.47-6.20) 1.30 (0.50-4.02) Hgb (g/dL) 11.10 (6.50-17.40) 12.60 (7.42-15.50) Wbc (10^3/µL) 14.19 (1.10-29.20) 14 (1.51-46) Na (mmol/L) 151.50 (12-199) 153 (68-211) K (mmol/L) 3.69 (1.50-6.40) 3.60 (2.40-4.90) Post-transplant surgical complications Lymphocele 31 (33.70%) 21 (33.30%) Hernia 1 (1.10%) 3 (4.80%) İleus 2 (2.20%) 0 (0%) Other 11 (12%) 8 (12.70%) None 47 (51.10%) 31 (49.20%) Post-transplant medical complications Drug 3 (3.30%) 3 (4.80%) Hyperparathyroidism (Secondary or tertiary) 2 (2.20%) 1 (1.60%) TXGMP 1 (1.10%) 0 (0%) AVN 9 (9.80%) 2 (3.20%) None 77 (83.70%) 57 (90.50%) SCD: Standard criteria of donor. ECD: Expanded criteria of donor. Hgb: Hemoglobin. Wbc: White blood cells. Na: Sodium. K:Potassium. TXGMP: Transplant glomerulopathy. AVN: Avascular necrosıs. Additional Declarations No competing interests reported. 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Ministry Of Health, Ankara Etlik City Hospital, Ankara,","correspondingAuthor":false,"prefix":"","firstName":"Emel","middleName":"Isıktas","lastName":"Sayilar","suffix":""},{"id":322136652,"identity":"3c7a4483-0760-4b1c-adcc-6cb48ef0a003","order_by":3,"name":"Abdulmecit Yildiz","email":"","orcid":"","institution":"Uludağ University","correspondingAuthor":false,"prefix":"","firstName":"Abdulmecit","middleName":"","lastName":"Yildiz","suffix":""},{"id":322136654,"identity":"a55e424d-0949-4499-88a1-3fddc195e6b9","order_by":4,"name":"Fatma Ezgi Can","email":"","orcid":"","institution":"Faculty of Medicine, Izmir Katip Celebi University, Department of Biostatistics and Medical Informatics","correspondingAuthor":false,"prefix":"","firstName":"Fatma","middleName":"Ezgi","lastName":"Can","suffix":""},{"id":322136655,"identity":"c4624ad1-c953-49b6-a81b-ad81aa1c96dc","order_by":5,"name":"Aysegul Oruc","email":"","orcid":"","institution":"Uludağ University","correspondingAuthor":false,"prefix":"","firstName":"Aysegul","middleName":"","lastName":"Oruc","suffix":""}],"badges":[],"createdAt":"2024-06-02 18:23:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4518032/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4518032/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":61001931,"identity":"ada8d37a-443b-4dab-bdfc-aac1e9f6d46c","added_by":"auto","created_at":"2024-07-24 13:15:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":43744,"visible":true,"origin":"","legend":"\u003cp\u003eSurvival graph for 1 year by MMF and acute rejection\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4518032/v1/80bec2d506c70401e47c6043.png"},{"id":61001929,"identity":"e5f216db-8577-4fbb-a707-b7b2294db716","added_by":"auto","created_at":"2024-07-24 13:15:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":44698,"visible":true,"origin":"","legend":"\u003cp\u003eSurvival graph for 3 years by MMF and acute rejection\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4518032/v1/972b9a7b91542d173c5d8ce9.png"},{"id":61001930,"identity":"951a19e3-94a3-45b9-9d21-8a374f280914","added_by":"auto","created_at":"2024-07-24 13:15:39","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":40096,"visible":true,"origin":"","legend":"\u003cp\u003eSurvival graph for 5 years by MMF and acute rejection.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4518032/v1/5f2e44204540c020ef02f7d1.png"},{"id":61918073,"identity":"8ae928c5-222b-4115-9edf-0e0c8b6cd7ee","added_by":"auto","created_at":"2024-08-07 05:27:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":600904,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4518032/v1/8aed3cb6-c156-4824-817f-1d7cf34b3ee6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eUse of Cadaveri̇c Margi̇nal Donors in Kidney Transplantation: a Single Center Experience\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe incidence of CKD also increases with an increase in comorbid diseases (such as hypertension and diabetes), and kidney transplantation remains the priority for patient survival as renal replacement therapy (RRT) in CKD. In previous studies, survival after transplantation from a suitable cadaver seems to be superior to that of other RRT (1-3). In recent years, the difficulties in finding donors and the decrease in the cadaver pool have increased the waiting time for dialysis and the interest in using marginal donors. In the USA, before 2001, the rate of cadaveric age \u0026ge; 60 years was 50%. The rate of cadavers over 60 years of age in France was 26.8% in 2005. In 2002, The Organ Procurement and Transplantation Network (OPTN) defined marginal donors and expanded donor criteria (ECD). ECD was defined as older kidney donors (\u0026gt; or =60 yr) or donors who are aged 50 to 59 year and have two of the following three features: Hypertension, terminal serum creatinine \u0026gt;1.5 mg/dl, or death from cerebrovascular accident. (2-7). Scoring systems such as the kidney donor profile index (KDPI) and kidney donor risk index (KDRI) are used to asses cadaver quality (8, 9). In our study, we retrospectively evaluated graft and patient survival and outcomes of cadaveric kidney transplantation according to the ECD and standard donor criteria (SCD) in our unit.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003ePatients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data, donor characteristics, recipient treatments, graft characteristics, and clinical and laboratory values of patients who underwent transplantation in our center between 01.07.2011 and 30.06.2016 using ECD (63 patients) and SCD (92 patients) were compared randomly and retrospectively from hospital records. ECD describes as older kidney donors (\u0026gt; or =60 yr) or donors who are aged 50 to 59 year and have two of the following three features: Hypertension, terminal serum creatinine \u0026gt;1.5 mg/dl, or death from cerebrovascular accident. The Kidney Donor Risk Index (KDRI) score was calculated by evaluating data on age, weight, height, race, creatinine, blood pressure, diabetes, and hepatitis C history. KDRI values were converted to KDPI values using Organ Procurement and Transplantation Network (OPTN) data (10). In our study, CNI-based regimens [Kidney Disease: Improving Global Outcomes (KDIGO transplantation guidelines)] were mostly used. As recommended by the guidelines, the cyclosporine level was tried to be kept around 200 ng/mL in the first 3 months, 150-200 ng/mL in the next 6 months, then 100-150ng/mL until the 2nd year, and 100 ng/mL after the 2nd year. The tacrolimus level was tried to be kept in the range of 12-15 ng/mL for the first 3 months, then 10-12 ng/mL for the first 6 months, then 8-10 ng/mL until the 2nd year, and 5.2-8 ng/mL after the 2nd year. The dose of mycophenolate mofetil was tried to be given as full as possible (2000 mg/day for mycophenolate mofetil, 1440 mg/day for mycophenolate sodium). The dose was reduced in patients with diarrhea, severe infection, risk of sepsis, thrombocytopenia, severe leukopenia, etc. (According to the Elite-Symphony Trial). The corticosteroid dose (prednisolone) was reduced to 5 mg/day after 6 months. Switching to mTOR was performed in patients who developed calcineurin toxicity (nephrotoxicity) (11). \u0026nbsp;Donors who did not meet the condition of being cadavers, such as those with a history of cancer, high risk of transmission, and active infection, were excluded from the study. Patients who did not have regular follow-ups during the specified period and were transferred to another center were also excluded from the study. We de-identified all patient details (12). Ethics committee approval was obtained with the decision dated 15.01.2019-2019-1/21 at the outer center. We allow that fellow researchers may reproduce our methodology. Our study was retrospective and permissions obtained from the ethics committee to share visual data and patient information.\u003cbr\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBiostatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData are expressed as mean \u0026plusmn; SD and median (min-max). Percentage change values were calculated as (postoperative value-preop value)/preoperative value for time-dependent values and used in intergroup comparisons. Mann-Whitney U test, independent sample t-test, Pearson chi-square test, Fisher exact test, and Fisher Freeman Halton test were used for comparisons. Survival times were calculated using Kaplan-Meier analysis, and factors were examined using the log-rank test. Cox regression analysis was used to determine the hazard ratios and risk factors. Statistical analyses were performed usingStatistical Package for Social Sciences for Windows [version 22.0; (SPSS, Chicago, IL, USA)]. Statistical significance was set at p\u0026lt; 0.05.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eAs expected the mean age of the SCD group was lower than that of the ECD group. The last and 24-hour urine volume were lower in the ECD group. Body mass index (BMI) was higher in the ECD group. The number of cadavers with a history of diabetes and hypertension was higher in the ECD group. Additionally, the cause of death due to trauma was more prominent in the SCD group. The cold ischemia time was longer in patients with ECD. The rates of HT and DM in recipients and the KDPI and KDRI scores were higher in the ECD group. When the recipients were evaluated, the history of HT was higher in transplant recipients from the ECD group. In terms of hospitalization due to infection, acute rejection, and graft and patient survival after transplantation, there was no change in the recipients according to the type of cadaver (Tables 1and 2).\u003c/p\u003e\n\u003cp\u003eThe incidence of primary non-functioning kidneys was higher in the ECD group. The firstmonth creatinine level was higher and the GFR level was lower in the ECD group (Table 3).\u003c/p\u003e\n\u003cp\u003eNo difference was observed between the two groups in terms of the surgical and medical complications observed after transplantation (Tables 4 and 5).\u003c/p\u003e\n\u003cp\u003eAccording to the 1, 3 and 5 year survival results (for graft), renal survival was longer in mycophenolate mofetil (MMF) users, and renal survival was adversely affected in patients with acute rejection (Figure 1-3).\u003c/p\u003e\n\u003cp\u003eWhen patient survival time was examined for 1, 3 and 5 year survival for patients, it was not statistically significant. No significant results were found in the multivariate analysis.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe need for renal replacement therapy has increased owing to an increase in the incidence and prevalence of chronic kidney diseases. In kidney transplantation, the need to find donors and cadavers and the length of stay of patients on dialysis have increased. Paired kidney exchange, dual kidney transplantation, and marginal donor use are used to meet patient needs. Considering the global increase in the elderly population, an increase in marginal donor use is expected in the future. In our country\u0026apos;s database, the donor rate between the ages of 45-64 was 36.05%, which was 5.36% over the age of 65 years. These rates increased compared to those in the previous year (29.72% and 4.04, respectively) (9, 13). The use of marginal donors affects both patient and graft survival (14). In transplants from elderly patients (\u0026gt; 60 years), graft and patient loss were higher at the end of the 1st and 5th years compared to those transplanted with standard criteria. In a study that evalueted, 1554 recipients from Switzerland, patient and graft survival were negatively affected when donor age increased (15, 16). As expected, in our study, age was higher in the ECD group than the SCD group. The incidence of rejection and primary nonfunctional grafts increased after the use of marginal donors. The incidence of a primary non-functioning kidney was approximayely 2% in patients with a KDPI \u0026ge;80. The rejection rate was 7% by the end of the 6th month. In a study in which 720 cadaveric donors were evaluated, acute rejection rates were higher in patients with a KDPI\u0026gt;85. In this study, the contribution of acute rejection rate to graft function at the end of the first year was not significant. In another study, 663 transplants analyzed and age-related acute rejections after three months had a negative effect on graft survival at the end of the 1st and 5th years. In addition, rejection rates were similar between the SCD and ECD groups in some studies. Acute rejection rates are high in patients with delayed graft (DGF) function (9, 17-20). In our study, no change was detected in the rejection rates in either group. In the regression analysis, the 1st, 3rd and 5th year graft survivals were poor in those who had an acute rejection attack. Rejection is thought to affect graft survival due to the effects of the primary disease and immunosuppressive therapies. Drug pharmacokinetics in elderly patients should also be considered, particulary with regard to the effectiveness of immunosuppressive therapies. Considering the patient\u0026apos;s clinical and side-effect profiles in terms of immunosuppressive therapies, it was determined that the pharmacokinetics of calcineurin inhibitors (CNI) and steroids changed, but MMF did not (21). However, CNI-free regimens based on reduced CNI exposure and mammalian target of rapamycin inhibitors (mTOR inhs) have shown acceptable results in appropriately selected ECD transplant recipients. CNI-free mTOR inhs -based therapy compared with MMF-based treatment in kidney transplantation with advanced-age donors was associated with an acceptable outcome, but increased proteinuria and acute rejection in mTOR inhs -treated patients was more detected. The best results with mTOR inhs have been found in patients without delayed graft function (22). In a multicenter study including 3143 patients, the combination of CNI and MMF increased graft survival and decreased acute rejection rates (23). Studies have shown that MMF plays a key role in immunosuppressive treatment regimens, and rejection and graft survival are adversely affected by dose reduction and discontinuation of the drug (24). In our study, MMF had a positive effect on 1st, 3rd and 5th year graft survival.\u003c/p\u003e\n\u003cp\u003eThe most important shortcomings of our study are that it was retrospective, the number of patients was small, and HLA and donor-specific antibodies could not be tested. In conclusion, acute rejection attacks negatively affect graft survival and MMF plays an important role in the RRT treatment protocol. Therefore, attention should be paid to immunosuppressive treatment and rejection in ECD transplant recipients. Therefore, dose and drug changes should be closely monitored.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eACKNOWLEDGEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWriting, preparation: YA, AE, and EIS. Statistical analysis: FEC. Data Collecting: YA\u003c/p\u003e\n\u003cp\u003eand; EIS. Pre-Evaluation: YA, AE, AY, and AO.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData and information about the article can be used with the permission of the journal publisher and the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCollins AJ, Foley RN, Gilbertson DT, Chen SC, United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl (2011) 2015;5(1):2-7.\u003c/li\u003e\n\u003cli\u003eNoble J, Jouve T, Malvezzi P, S\u0026uuml;sal C, Rostaing L. Transplantation of Marginal Organs: Immunological Aspects and Therapeutic Perspectives in Kidney Transplantation. Front Immunol. 2020;10:3142.\u003c/li\u003e\n\u003cli\u003eFiliopoulos V, Boletis JN. Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression? World J Transplant. 2016;6(1):103-14.\u003c/li\u003e\n\u003cli\u003eWang Z, Durai P, Tiong HY. Expanded criteria donors in deceased donor kidney transplantation - An Asian perspective. Indian J Urol. 2020;36(2):89-94.\u003c/li\u003e\n\u003cli\u003eAudard V, Matignon M, Dahan K, Lang P, Grimbert P. Renal transplantation from extended criteria cadavericdonors: problems and perspectives overview. Transpl Int. 2008;21(1):11-7.\u003c/li\u003e\n\u003cli\u003eOru\u0026ccedil; A, Ersoy A, Ayar Y, Akg\u0026uuml;r S, Yildiz A. Exclusion Reasons of Cadaveric Kidney Transplantation Candidates. Turkish J Nephrol 2018; 27: 82-6.\u003c/li\u003e\n\u003cli\u003e\u0026Ccedil;oban Ş, Yıldız S, Bozkaya E, Derici ZS, \u0026Uuml;nl\u0026uuml; M, \u0026Ccedil;elik A, Sifil A et al. Evaluation of Morbidity and Patient and Graft Survival in Kidney Transplant Recipients: Experience of Dokuz Eylul University Hospital. Turkish J Nephrol 2017; 26: 41-7.\u003c/li\u003e\n\u003cli\u003eSexton DJ, O\u0026apos;Kelly P, Kennedy C, Denton M, de Freitas DG, Magee C, O\u0026apos;Seaghdha CM, Conlon PJ. Assessing the discrimination of the Kidney Donor Risk Index/Kidney Donor Profile Index scores for allograft failure and estimated glomerular filtration rate in Ireland\u0026apos;s National Kidney Transplant Programme. Clin Kidney J. 2019;12(4):569- 573.\u003c/li\u003e\n\u003cli\u003eDoshi MD, Reese PP, Hall IE, Schr\u0026ouml;ppel B, Ficek J, Formica RN, Weng FL et al. Utility of Applying Quality Assessment Tools for Kidneys With KDPI 80. Transplantation. 2017;101(6):1125-33.\u003c/li\u003e\n\u003cli\u003eoptn.transplant.hrsa.gov \u0026rsaquo; media \u0026rsaquo; kdpi_guide. A Guide to Calculating and Interpreting the Kidney Donor Profle Index (KDPI).\u003c/li\u003e\n\u003cli\u003eHeemann U, Abramowicz D, Spasovski G, Vanholder R; European Renal Best Practice Work Group on Kidney Transplantation. Endorsement of the Kidney Disease Improving Global Outcomes (KDIGO) guidelines on kidney transplantation: a European Renal Best Practice (ERBP) position statement. Nephrol Dial Transplant. 2011;26(7):2099-106.\u003c/li\u003e\n\u003cli\u003evon Elm E, Altman DG, Egger M, Pocock SJ, G\u0026oslash;tzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 2007;147(8):573-7.\u003c/li\u003e\n\u003cli\u003eRegıstry Of The Nephrology, Dıalysıs And Transplantatıon in Turkey, Regıstry 2019 and 2020. Mınıstry Of Health and Turkısh Socıety of Nephrology Joınt Report: pp 52- 3. Editors: Suleymanlar G, Ates K, Seyahi N, Kocyigit I.\u003c/li\u003e\n\u003cli\u003eMaggiore U, Cravedi P. The marginal kidney donor. Curr Opin Organ Transplant. 2014;19(4):372-80.\u003c/li\u003e\n\u003cli\u003eMa MK, Lim WH, Craig JC, Russ GR, Chapman JR, Wong G. Mortality among Younger and Older Recipients of Kidney Transplants from Expanded Criteria Donors Compared with Standard Criteria Donors. Clin J Am Soc Nephrol. 2016;11(1):128-36.\u003c/li\u003e\n\u003cli\u003eKuhn C, Lang BM, L\u0026ouml;rcher S, Karolin A, Binet I, Beldi G, Golshayan D et al. Outcome of kidney transplantation from very senior donors in Switzerland - a national cohort study. Transpl Int 2021;34(4):689-99.\u003c/li\u003e\n\u003cli\u003eGandolfini I, Buzio C, Zanelli P, Palmisano A, Cremaschi E, Vaglio A, Piotti G et al. The Kidney Donor Profile Index (KDPI) of marginal donors allocated by standardized pretransplant donor biopsy assessment: distribution and association with graft outcomes. Am J Transplant. 2014;14(11):2515-25.\u003c/li\u003e\n\u003cli\u003eBae S, Massie AB, Thomas AG, Bahn G, Luo X, Jackson KR, Ottmann SE et al. Who can tolerate a marginal kidney? Predicting survival after deceased donor kidney transplant by donor-recipient combination. Am J Transplant. 2019;19(2):425-433.\u003c/li\u003e\n\u003cli\u003eArias-Cabrales CE, P\u0026eacute;rez-S\u0026aacute;ez MJ, Redondo-Pach\u0026oacute;n D, Buxeda A, Burballa C, Duran X, Mir M et al. Relevance of KDPI value and acute rejection on kidney transplant outcomes in recipients with delayed graft function - a retrospective study. Transpl Int. 2020;33(9):1071-7.\u003c/li\u003e\n\u003cli\u003eJalalzadeh M, Mousavinasab N, Peyrovi S, Ghadiani MH. The impact of acute rejection in kidney transplantation on long-term allograft and patient outcome. Nephrourol Mon. 2015 Jan 20;7(1):e24439.\u003c/li\u003e\n\u003cli\u003ePeeters LEJ, Andrews LM, Hesselink DA, de Winter BCM, van Gelder T. Personalized immunosuppression in elderly renal transplant recipients. Pharmacol Res. 2018;130:303-7.\u003c/li\u003e\n\u003cli\u003eDiekmann F, Guti\u0026eacute;rrez-Dalmau A, L\u0026oacute;pez S, Cof\u0026aacute;n F, Esforzado N, Ricart MJ, Rossich E et al. Influence of sirolimus on proteinuria in de novo kidney transplantation with expanded criteria donors: comparison of two CNI-free protocols. Nephrol Dial Transplant. 2007;22(8):2316-21.\u003c/li\u003e\n\u003cli\u003eKnight SR, Russell NK, Barcena L, Morris PJ. Mycophenolate mofetil decreases acute rejection and may improve graft survival in renal transplant recipients when compared with azathioprine: a systematic review. Transplantation 2009;87(6):785-94.\u003c/li\u003e\n\u003cli\u003eSu VCh, Greanya ED, Ensom MH. Impact of Mycophenolate Mofetil Dose Reduction on Allograft Outcomes in Kidney Transplant Recipients on Tacrolimus-Based Regimens: A Systematic Review. Ann Pharmacother. 2011;45(2):248-57.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1. Comparisons about donor type\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"507\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eDonor Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003eSCD\u003c/p\u003e\n \u003cp\u003e(n=92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003eECD\u003c/p\u003e\n \u003cp\u003e(n=63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eGender (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e63 (68.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e38 (60.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.381\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e29 (31.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e25 (39.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eAge (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e41 (20-59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e62 (42-86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eDonor height (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e170 (150-196)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e170 (150-185)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.133\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eDonor kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e70 (50-115)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e75 (52-115)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eThe last urine (cc)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e180 (10-1000)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e100 (20-1400)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.023\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003e24-hour urine (cc)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e4255 (750-14950)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e3200 (800-7500)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.030\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eDonor BMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e24.71\u0026plusmn;3.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e26.96\u0026plusmn;3.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eDM in donor (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e27 (42.90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e92 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e36 (57.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eHT in donor (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e8 (8.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e59 (93.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e84 (91.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e4 (6.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eCause of death (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eCVA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e62 (67.40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e60 (95.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eTrauma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e24 (26.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.60%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e6 (6.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e2 (3.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eİntensive Care Hospitalization (day)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e3 (1-21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e3 (1-10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eCold ischemia (hour)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e10 (1-21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e12 (4-36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eHbsAg (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003ePozitive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e2 (2.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e3 (4.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.397\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e90 (97.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e60 (95.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eantiHbs (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003ePozitive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e39 (42.40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e53 (57.60%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.241\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e20 (31.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e43 (68.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e8 (8.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e59 (93.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e84 (91.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e4 (6.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eKDPI (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e56 (19-88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e97 (65-100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eKDRI (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e1.06 (0.73-1.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e1.93 (1.16-3.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eHLA missmatch (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1-6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1-6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.865\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDM: Diabetes Mellitus. BMI: Boddy mass index. CVA: Cerebrovascular accident. HT: Hypertension. HbsAg: Hepatitis B surface antigen. antiHbs: Hepatitis B surface antibody. KDPI: Kidney donor profile index. KDRI: Kidney donor resistive index. CMV: Cytomegalovirus.\u003c/p\u003e\n\u003cp\u003eTable 2. Characteristics of recipients\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"507\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eRecipient Age (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003eSCD\u003c/p\u003e\n \u003cp\u003e(n= 92)\u003c/p\u003e\n \u003cp\u003e42.50\u0026plusmn;13.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003eECD\u003c/p\u003e\n \u003cp\u003e(n=63)\u003c/p\u003e\n \u003cp\u003e42.84\u0026plusmn;14.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.879\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eHT in recipient (n, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e27 (42.90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e92 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e36 (57.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eDM in recipient (n, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e19 (20.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e16 (25.40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.618\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e73 (79.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e47 (74.60%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eHospitalization after Tx (n, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eUTI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e20 (21.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e16 (25.40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"6\"\u003e\n \u003cp\u003e0.926\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003ePneumonia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e25 (27.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e15 (23.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eSurgical complication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e11 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e9 (14.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eRejection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e8 (8.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e6 (9.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e8 (8.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e3 (4.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e20 (21.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e14 (22.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eGraft loss (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e12 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e10 (16.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.763\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e80 (87%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e52 (83.90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eMortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eAlive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e76 (82.60%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e48 (76.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eRejection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e5 (5.40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e9 (14.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eExitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e11 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e6 (9.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDM: Diabetes Mellitus. HT: Hypertension. Tx: Transplantation. UTI: Urinary tract infection.\u003c/p\u003e\n\u003cp\u003eTable 3. Comparisons about primer treatments\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"507\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003eSCD\u003c/p\u003e\n \u003cp\u003e(n=92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003eECD\u003c/p\u003e\n \u003cp\u003e(n=63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eCNI (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eCyclosporine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e49 (53.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e26 (41.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eTacrolimus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e43 (46.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e37 (58.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eMMF (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e84 (91.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e55 (87.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e8 (8.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e8 (12.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003emTOR (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e6 (6.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e6 (9.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.549\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e86 (93.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e57 (90.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary non-functioning kidney (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e5 (7.90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e92 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e58 (92.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eAcute Rejection (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e19 (20.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e15 (23.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.788\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e73 (79.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e48 (76.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eDGF (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e13 (14.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e14 (22.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.276\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e79 (85.90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e49 (77.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eATN (n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e31 (33.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e20 (31.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.936\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.19047619047619%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e61 (66.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.952380952380953%\" valign=\"top\"\u003e\n \u003cp\u003e43 (68.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCNI: Calcineurin inhibitors. MMF: Mycophenolate mofetil. mTOR: The mammalian target of rapamycin. DGF: Delayed graft function. ATN: Acute tubular necrosis.\u003c/p\u003e\n\u003cp\u003eTable 4. Comparisons about serum creatinine and GFR\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"507\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003eSCD\u003c/p\u003e\n \u003cp\u003e(n=92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003eECD\u003c/p\u003e\n \u003cp\u003e(n=63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eSerum creatinine first month (mg/dL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e1.30 (0.53-8.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e1.61 (0.46-14.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.014\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eSerum creatinine sixth month*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e0.08 (-1:1.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e-0.03 (-0.84:1.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eSerum creatinine twelfth month*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e-0.02 (-1:3.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e0.01 (-0.85:5.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.208\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eSerum creatinine final*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e-0.04 (-1:9.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e0 (-0.82:6.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.510\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eGFR first month (ml/min/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e57.67 (7-202)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e44 (3.57-202)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eGFR sixth month*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e-0.07 (-1:65.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e0.04 (-0.59:4.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eGFR twelfth month*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e-0.05 (-1:7.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e-0.07 (-0.90:5.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.572\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.039525691699605%\" valign=\"top\"\u003e\n \u003cp\u003eGFR final*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\" valign=\"top\"\u003e\n \u003cp\u003e-0.07 (-1:6.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.691699604743082%\" valign=\"top\"\u003e\n \u003cp\u003e-0 (-0.90:4.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.99604743083004%\" valign=\"top\"\u003e\n \u003cp\u003e0.445\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* Percentage change values was calculated and compared. GFR: Glomerular filtration rate.\u003c/p\u003e\n\u003cp\u003eTable 5. Post-transplant surgical and medical complications\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"535\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003eSCD\u003c/p\u003e\n \u003cp\u003e(n=92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003eECD\u003c/p\u003e\n \u003cp\u003e(n=63)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eSerum urea (mg/dL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e42 (6-114)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e57 (15-137)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eSerum creatinine (mg/dL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e1.10 (0.47-6.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e1.30 (0.50-4.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eHgb (g/dL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e11.10 (6.50-17.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e12.60 (7.42-15.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eWbc (10^3/\u0026micro;L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e14.19 (1.10-29.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e14 (1.51-46)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eNa (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e151.50 (12-199)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e153 (68-211)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eK (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e3.69 (1.50-6.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e3.60 (2.40-4.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003ePost-transplant surgical complications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eLymphocele\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e31 (33.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e21 (33.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eHernia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e3 (4.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eİleus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e2 (2.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e11 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e8 (12.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e47 (51.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e31 (49.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003ePost-transplant medical complications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eDrug\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e3 (3.30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e3 (4.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eHyperparathyroidism (Secondary or tertiary)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e2 (2.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.60%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eTXGMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eAVN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e9 (9.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e2 (3.20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.56554307116105%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.84269662921348%\" valign=\"top\"\u003e\n \u003cp\u003e77 (83.70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.591760299625467%\" valign=\"top\"\u003e\n \u003cp\u003e57 (90.50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSCD: Standard criteria of donor. ECD: Expanded criteria of donor. Hgb: Hemoglobin. Wbc: White blood cells. Na: Sodium. K:Potassium. TXGMP: Transplant glomerulopathy. AVN: Avascular necrosıs.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Acute rejection, cadaveric transplantation, marginal donor, mycophenolate mofetil","lastPublishedDoi":"10.21203/rs.3.rs-4518032/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4518032/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003eThe increase in the need for organs and decrease in the cadaver pool have led to a tendency towards organ transplantation from marginal donors. In our study, patients who underwent transplantation based on the standard and expanded donor criteria were compared in terms of factors affecting graft survival.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003eData of patients who underwent transplantation from cadavers with standard and extended criteria (SCD, ECD) between 01.07.2011 and 30.06.2016 evaluated retrospectively. Donor characteristics, treatment type, response and graft characteristics, 1st, 3rd and 5th year graft survival, and acute rejection rates were analyzed, retrospectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The causes of death, cerebrovascular accidents were more common in the ECD group (p\u0026lt;0.001). Hypertension and diabetes were more common in both donor groups and detected more frequently in recipients in the ECD group (p\u0026lt;0.001). The absence of mycophenolate mofetil (MMF) use and the presence of an acute rejection attack adversely affected graft survival at the end of the 1st, 3rd and 5th years.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003eThe use of marginal donors is widespread. Appropriate monitoring of patients undergoing immunosuppressive therapy, especially using MMF and the presence of acute rejection, affects graft survival. Therefore, attention should be paid to immunosuppressive treatment and rejection in ECD transplant recipients.\u003c/p\u003e","manuscriptTitle":"Use of Cadaveri̇c Margi̇nal Donors in Kidney Transplantation: a Single Center Experience","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-24 13:15:33","doi":"10.21203/rs.3.rs-4518032/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bb99d2ba-4314-4a8a-ba51-8685488aa089","owner":[],"postedDate":"July 24th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-08-07T05:18:55+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-24 13:15:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4518032","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4518032","identity":"rs-4518032","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}