Introduction: Renal transplantation has significant mortality benefits and offers better quality of life after renal transplant. The ESRD population is increasing every year and so is the number of transplants, yet the ESRD population waiting for transplant is significantly high. Despite the increasing number of renal transplants every year, the number of patients reaching ESRD is still high. To bridge this gap and to increase the donor pool, India has seen a significant improvement in cadaver renal transplants, abo incompatible and swap transplants over the last decade. There is no uniform consensus across the country regarding discard of the deceased donor kidneys available for transplant. There is a dearth for published data available regarding the overall percentage of discards in India and of the various donor parameters involved.
Methodology: This study used data from the Jeevandan website portal which has data on all deceased donors, wait-listed candidates, and transplant recipients in the state of Telangana. We conducted a retrospective cohort study to analyse deceased donor kidneys recovered for transplantation from 2014-2022. A total of 17 parameters, which include Age, Gender, donor hospital (government/private), Height, weight, BMI, blood group,  cause of death, ECD, duration of ICU stay, number of  ionotropic supports, terminal creatinine at the time of donation, diabetes, hypertension, serological status such as HbsAg and HCV, KDPI of the donor of past 9  years  were retrieved from the Jeevandan website portal and analysed.
Results: Out of 1052 donations which happened between 2014-2022, Both kidneys were accepted from 781 (73.9%) donors, 52 donors (4.9%) had single kidney discard, 223 (21.1%) donors had dual kidney discards. Mean age in transplanted group (dual kidney accept) was 38.43 years, whereas it is 43.3 and 54.8 in single and dual discard group respectively. Females and Brain death due to RTA were more likely to be accepted whereas higher KDPI and terminal serum creatinine, History of diabetes and/or hypertension, ECD donors, HbsAg positive donors were more likely to be discarded, which were statistically significant.
Conclusion: This is a pioneering study on the factors leading to discard of deceased kidney donors in the state of Telangana, India.