Function Based Donor/Recipient Matching in ECD Kidney Transplantation Using the Creatinine Clearance Match Ratio (CCMR)

Expanded criteria donor kidneys (ECD) have the potential to greatly increase the number of kidneys available for transplantation; however utilization is limited by poorer outcomes [1-5]. One strategy to improve outcomes and secondarily utilization is improved matching of kidneys based on recipient factors such as surface area [6,7], kidney graft size to recipient weight [8] and kidney weight to recipient weight [9,10]. Recently our group developed the creatinine clearance match ratio (CCMR) as an improved matching technique. The CCMR is calculated using a manipulation of the Cockcroft-Gault equation estimating the creatinine clearance required by the recipient at a serum creatinine level of 1.0 thereby producing an estimated value for an individual’s creatinine production and in intellectual shorthand, “nephron need” [11,12]. We simply asked; “how much Creatinine clearance would a potential recipient require to achieve a post-transplant serum creatinine of 1.0,” and then created a variable utilizing Cockcroft-Gault estimated donor creatinine clearance from known donor variables. Simplification results in the equation below.