Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline
Underutilization of deceased donor organs has worsened the gap in the number of kidneys available for transplantation. The purpose of this clinical practice guideline is to provide recommendations on the utilization of donor kidneys at risk of discard. Six conditional recommendations were made all w...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-06-01
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| Series: | Transplant International |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14596/full |
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| author | Joanna C. Dionne Joanna C. Dionne Joanna C. Dionne Patricia Campbell Héloïse Cardinal Héloïse Cardinal Tatiana Giannidis Aviva Goldberg S. Joseph Kim S. Joseph Kim Greg Knoll Michel Pâquet Christina Parsons Yuhong Yuan Rahul Mainra |
| author_facet | Joanna C. Dionne Joanna C. Dionne Joanna C. Dionne Patricia Campbell Héloïse Cardinal Héloïse Cardinal Tatiana Giannidis Aviva Goldberg S. Joseph Kim S. Joseph Kim Greg Knoll Michel Pâquet Christina Parsons Yuhong Yuan Rahul Mainra |
| author_sort | Joanna C. Dionne |
| collection | DOAJ |
| description | Underutilization of deceased donor organs has worsened the gap in the number of kidneys available for transplantation. The purpose of this clinical practice guideline is to provide recommendations on the utilization of donor kidneys at risk of discard. Six conditional recommendations were made all with very low certainty of evidence: 1) We suggest utilizing extended criteria donor (ECD) kidneys for transplantation rather than remaining on the wait list and continuing with dialysis; 2) We suggest utilizing kidneys from ECD versus non-ECD in selected transplant candidates; 3) We suggest that organs from older kidney donors can be used in selected transplant candidates who may derive benefit from them; 4) We suggest that kidneys from deceased donors with acute kidney injury can be used for transplantation based on clinician assessment and donor factors; 5) We suggest that donor kidneys with acute kidney injury from either ECD or non-ECD be used for kidney transplantation; 6) We suggest using kidneys from donors after death determination by circulatory criteria for transplantation. This clinical practice guideline provides evidence for the use of deceased donor kidneys that are at risk of discard and may improve the shared decision-making between transplant physicians and wait-listed patients. |
| format | Article |
| id | doaj-art-3ee63bed77d2441fa8dab44cb2afea9a |
| institution | DOAJ |
| issn | 1432-2277 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Transplant International |
| spelling | doaj-art-3ee63bed77d2441fa8dab44cb2afea9a2025-08-20T03:23:59ZengFrontiers Media S.A.Transplant International1432-22772025-06-013810.3389/ti.2025.1459614596Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice GuidelineJoanna C. Dionne0Joanna C. Dionne1Joanna C. Dionne2Patricia Campbell3Héloïse Cardinal4Héloïse Cardinal5Tatiana Giannidis6Aviva Goldberg7S. Joseph Kim8S. Joseph Kim9Greg Knoll10Michel Pâquet11Christina Parsons12Yuhong Yuan13Rahul Mainra14Department of Medicine, McMaster University, Hamilton, ON, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, CanadaDivision of Gastroenterology, McMaster University, Hamilton, ON, CanadaDepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, CanadaCentre de Recherche du Centre Hospitalier de l’Université de Montréal, Montreal, QC, CanadaDivision of Nephrology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, CanadaDepartment of Medicine, McMaster University, Hamilton, ON, CanadaDepartment of Pediatrics and Child Health, University of Manitoba Max Rady College of Medicine, Winnipeg, MB, CanadaDivision of Nephrology, Department of Medicine, University of Toronto, Toronto, ON, CanadaAjmera Transplant Centre, University Health Network, Toronto, ON, Canada0Division of Nephrology, Department of Medicine, University of Ottawa and the Ottawa Hospital Research Institute, Ottawa, ON, CanadaDivision of Nephrology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada1Canadian Blood Services, Ottawa, ON, CanadaDivision of Gastroenterology, McMaster University, Hamilton, ON, Canada2Division of Nephrology, Department of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaUnderutilization of deceased donor organs has worsened the gap in the number of kidneys available for transplantation. The purpose of this clinical practice guideline is to provide recommendations on the utilization of donor kidneys at risk of discard. Six conditional recommendations were made all with very low certainty of evidence: 1) We suggest utilizing extended criteria donor (ECD) kidneys for transplantation rather than remaining on the wait list and continuing with dialysis; 2) We suggest utilizing kidneys from ECD versus non-ECD in selected transplant candidates; 3) We suggest that organs from older kidney donors can be used in selected transplant candidates who may derive benefit from them; 4) We suggest that kidneys from deceased donors with acute kidney injury can be used for transplantation based on clinician assessment and donor factors; 5) We suggest that donor kidneys with acute kidney injury from either ECD or non-ECD be used for kidney transplantation; 6) We suggest using kidneys from donors after death determination by circulatory criteria for transplantation. This clinical practice guideline provides evidence for the use of deceased donor kidneys that are at risk of discard and may improve the shared decision-making between transplant physicians and wait-listed patients.https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14596/fullkidney transplantdecision makingutilizationorgan discardclinical practice guideline |
| spellingShingle | Joanna C. Dionne Joanna C. Dionne Joanna C. Dionne Patricia Campbell Héloïse Cardinal Héloïse Cardinal Tatiana Giannidis Aviva Goldberg S. Joseph Kim S. Joseph Kim Greg Knoll Michel Pâquet Christina Parsons Yuhong Yuan Rahul Mainra Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline Transplant International kidney transplant decision making utilization organ discard clinical practice guideline |
| title | Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline |
| title_full | Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline |
| title_fullStr | Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline |
| title_full_unstemmed | Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline |
| title_short | Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline |
| title_sort | optimizing the use of deceased donor kidneys at risk of discard a clinical practice guideline |
| topic | kidney transplant decision making utilization organ discard clinical practice guideline |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14596/full |
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