There is a critical shortage of organs available for transplantation. To combat the growing discrepancy between patients on the wait list and available donor kidneys, the United Network for Organ Sharing introduced a policy in 2001 for the use of expanded criteria deceased organ donors. These expanded criteria donors are defined as deceased donors older than 60 years of age, or donors between the ages of 50 and 59 years of age with two of the following: history of hypertension, history of cerebrovascular accident, or terminal serum creatinine > 1.5 mg/dL. These expanded criteria donors have an inherent reduced renal graft viability that translates into a relative risk of graft failure exceeding 1.7 when compared to an ideal donor. Age and terminal serum creatinine have been established as risk factors for graft survival. In this study we attempt to determine the relative impact of donor age and terminal serum creatinine on patient and graft survival.