Donor Quality Scoring Systems and Early Renal Function Measurements in Kidney Transplantation

Over the last years, an extensive improvement in the use of non-standard kidney allografts from deceased donors has been observed due to a chronic scarcity in the number of available donors. However, use of these donors seems to give worse results, higher delayed graft function (DGF) and rejection rates and briefer graft survivals. Nevertheless, a standardized definition of non-standard donor is still under debate. On these grounds, several studies have focalized on the importance of events immediately before or early post-transplant in determining allograft outcome: introduction of scores based on peri-operative features capable to predict graft function may yield huge implications for organ allocation policies, as well as for immediate and late clinical and immunological management of recipients. In fact, if pre-KT information could accurately predict suboptimal early graft function, the success of various mechanical, immunosuppressive and organ allocation strategies may be improved. The aim of this review is to analyze the different preand post-transplant score systems, detecting their role in the clinical practice and comparing them in terms of prognostic ability.