Raimundo M García Del Moral Martín1, Juan Antonio Retamero Díaz2, Mercedes Cava Molina2, Belen M Cobacho Tornel3, Juan Bravo Soto4, Antonio Osuna Ortega4, Francisco O'Valle Ravassa5. 1. Unidad de Cuidados Intensivos, Coordinación de trasplantes, AGS de Granada, España. Electronic address: rmgdelmoral@gmail.com. 2. Unidad Intercentros de Anatomía Patológica, CHU de Granada, Granada, España. 3. Departamento de Métodos Cualitativos e Informáticos, Universidad Politécnica de Cartagena, Granada, España. 4. Unidad Intercentros de Nefrología, CHU de Granada, Granada, España. 5. Departamento de Anatomía Patológica e Historia de la Ciencia, Universidad de Granada, Granada, España.
Abstract
INTRODUCTION: KDRI / KDPI are tools use in kidney donor evaluation. It has been proposed as a substitute of, or complementary to preimplantation renal biopsy. These scores has not been validated in Spain. OBJECTIVE: 1) To investigate the concordance between KDPI and histological scores (preimplantation renal biopsy) and 2) To assess the relationship between KDRI, KDPI and histological score on graft survival in the expanded criteria donors group. METHODOLOGY: Retrospective cohort study from 1 January 1998 until 31 December 2010. RESULTS: During the study 120 donors were recruited, that resulted in 220 preimplantation renal biopsies. 144 (65%) grafts were considered suitable for kidney transplantation. 76 (34.5%) were discarded. Median follow up has been 6.4 years (sd 3.9). Median age 63.1 years (sd 8.2), males (145; 65.9%), non-diabetic (191; 86.8%) and without another cardiovascular risk factors (173; 78.6%). 153 (69.5%) donors died of cerebrovascular disease. There were significant differences in KDRI/KDPI score in both groups 1.56/89 (sd 0.22) vs 1.66/93 (sd 0.15), p<0.01). The KDPI showed moderate concordance and correlation with the histological score (AUC 0.64 / correlation coefficient 0.24, p <0.01). KDPI (HR 24.3, p<0.01) and KDRI (HR 23.3, p<0.01) scores were associated with graft survival in multivariate analysis. CONCLUSION: 1) KPDI and histological scores show moderate concordance. The utility of both scores as combined tools it has to be determined. 2) KDPI score, and especially KDRI score, are valid for estimating graft survival and combined with the biopsy can help to individualized decision making in the expanded criteria donors pool.
INTRODUCTION: KDRI / KDPI are tools use in kidney donor evaluation. It has been proposed as a substitute of, or complementary to preimplantation renal biopsy. These scores has not been validated in Spain. OBJECTIVE: 1) To investigate the concordance between KDPI and histological scores (preimplantation renal biopsy) and 2) To assess the relationship between KDRI, KDPI and histological score on graft survival in the expanded criteria donors group. METHODOLOGY: Retrospective cohort study from 1 January 1998 until 31 December 2010. RESULTS: During the study 120 donors were recruited, that resulted in 220 preimplantation renal biopsies. 144 (65%) grafts were considered suitable for kidney transplantation. 76 (34.5%) were discarded. Median follow up has been 6.4 years (sd 3.9). Median age 63.1 years (sd 8.2), males (145; 65.9%), non-diabetic (191; 86.8%) and without another cardiovascular risk factors (173; 78.6%). 153 (69.5%) donors died of cerebrovascular disease. There were significant differences in KDRI/KDPI score in both groups 1.56/89 (sd 0.22) vs 1.66/93 (sd 0.15), p<0.01). The KDPI showed moderate concordance and correlation with the histological score (AUC 0.64 / correlation coefficient 0.24, p <0.01). KDPI (HR 24.3, p<0.01) and KDRI (HR 23.3, p<0.01) scores were associated with graft survival in multivariate analysis. CONCLUSION: 1) KPDI and histological scores show moderate concordance. The utility of both scores as combined tools it has to be determined. 2) KDPI score, and especially KDRI score, are valid for estimating graft survival and combined with the biopsy can help to individualized decision making in the expanded criteria donors pool.
Authors: F Villanego; L A Vigara; J M Cazorla; J Naranjo; L Atienza; A M Garcia; M E Montero; M C Minguez; T Garcia; A Mazuecos Journal: Transpl Int Date: 2022-06-06 Impact factor: 3.842
Authors: Quirin Bachmann; Flora Haberfellner; Maike Büttner-Herold; Carlos Torrez; Bernhard Haller; Volker Assfalg; Lutz Renders; Kerstin Amann; Uwe Heemann; Christoph Schmaderer; Stephan Kemmner Journal: Front Med (Lausanne) Date: 2022-04-29
Authors: Armando Coca; Carlos Arias-Cabrales; Ana Lucía Valencia; Carla Burballa; Juan Bustamante-Munguira; Dolores Redondo-Pachón; Isabel Acosta-Ochoa; Marta Crespo; Jesús Bustamante; Alicia Mendiluce; Julio Pascual; María José Pérez-Saéz Journal: Sci Rep Date: 2020-10-13 Impact factor: 4.379