Background: Worldwide there are no uniformly acceptable deceased donor selection criteria for renal transplantation. There are national and international guidelines available based on which most of the units make their own locally agreed policies depending on their recourses and expertise. These policies are flexible to change over time to accommodate unit's growth and development. During making new strategies it's important to reflect on one's own practices and learning from others experience. In this present study we have reflected on our deceased donor selection criteria for organ transplantation by looking into the offers that we have rejected for renal transplantation but got accepted by other centres for transplantation.

Materials and Methods: Between Jan-2012 to June-2013 we retrospectively analysed our transplant and NHSBT data for the offer rejected. We recorded donor demographics, retrieval information, and reasons for decline by our centre. We then recorded outcome of those kidneys after transplant from other centres.

Results: During this 18 months period we declined 68 donors offers. They included 18 DCD and 50 DBD offers. Out of 18 DCD rejected kidneys 72% were working at 1 year after transplant at other centre. From 50 DBD offers 86% were working at 1 year. Combination of age more than 60 with hypertension accounted for 26% (N=18) rejected offers, addition of diabetes to above combination accounted for 12% (N=8). 20% (N=14, DCD=4, DBD=10) donors were above 70 years of age. A total of 8 dual kidney transplants were performed 2 from DCD pairs and 6 from DBD pairs. 6 pairs were from donors above 70 years.

Conclusions: Learning from these outcomes and with availability of resources we have successfully developed a dual kidney program in addition to further relaxing our criteria for expanding criteria donor.

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