Expanded Criteria Donor

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Expanded Criteria Donor (ECD) is normally associated with deceased or living kidney donors. They are also referred to as donors with "medical complexities".[1] ECD donors are normally aged 60 years or older, or over 50 years with at least two of the following conditions: hypertension history, serum creatinine > 1.5 mg/dl or cause of death from cerebrovascular accident.

Of the 9319 living kidney donations reported in the American Organ Procurement and Transplantation Network (OPTN) / United Network for Organ Sharing (UNOS) database from July 2004 to December 2005, 368 (4.0%) donors were over the age of 60 (of which 86 [0.9%] were over the age of 65), 956 (10.3%) had hypertension, 2785 (29.9%) had an eGFR < 80 mL/min per 1.73 m2 (of which 392 [4.2%] had an eGFR < 60 mL/min per 1.73 m2) and 1194 (12.8%) had a BMI > 30 kg/m2 (of which 250 [2.7%] had a BMI > 35 kg/m2)[2]

The concept of ECD was raised to address the discrepancy between demand and supply in kidney transplantation.


  1. ^ Reese R, Caplan A, Kesselheim A, Bloom R. Creating a medical, ethical, and legal framework for complex living kidney donors. Clin J Am Soc Nephrol 2006; 1: 1148–1153.
  2. ^ Iordanous, Y. et al. Recipient Outcomes for Expanded Criteria Living Kidney Donors: The Disconnect Between Current Evidence and Practice. American Journal of Transplantation 2009; 9: 1558–1573

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