Measurement of chronic damage in the donor kidney and graft survival

Background. So-called marginal kidneys are used increasingly in renal transplantation, but features of marginal kidneys are disputed. Methods. To help define marginal, a morphometric measure, the index of chronic damage, was applied retrospectively to 500 implantation biopsy specimens of cadaveric grafts, and death-censored graft survival was calculated, up to 14 years after transplantation. Results. An index of 0% (n=242) was associated with better survival than 1%, with little difference between 1% and 39% (n=249). An index of 40% or more (n=9) was associated with the worst survival (chi(2)=14.2, 2 df, P