Carlos Arias-Cabrales1, María José Pérez-Sáez1, Dolores Redondo-Pachón1, Anna Buxeda1, Carla Burballa1, Sheila Bermejo1, Adriana Sierra1, Marisa Mir1, Andrea Burón2, Ana Zapatero1, Marta Crespo1, Julio Pascual3. 1. IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Department of Intensive Care Medicine, Transplant Coordination Unit, Hospital del Mar, Barcelona, Spain. 2. IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Epidemiology and Evaluation Department, Hospital del Mar, Barcelona, Spain; REDISSEC (Health Services Research on Chronic Patients Network), Madrid, Spain. 3. IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Department of Intensive Care Medicine, Transplant Coordination Unit, Hospital del Mar, Barcelona, Spain. Electronic address: julpascual@gmail.com.
Abstract
INTRODUCTION: Kidney donor shortage requires expanding donor selection criteria, as well as use of objective tools to minimize the percentage of discarded organs. Some donor pre-transplant variables such as age, standard/expanded criteria donor (SCD/ECD) definition and calculation of the Kidney Donor Profile Index (KDPI), have demonstrated correlations with patient and graft outcomes. We aimed to establish the accuracy of the three models to determine the prognostic value of kidney transplantation (KT) major outcomes. MATERIAL AND METHODS: We performed a retrospective study in deceased donor KTs at our institution. Unadjusted Cox and Kaplan-Meier survival, and multivariate Cox analyses were fitted to analyze the impact of donor age, SCD/ECD and KDPI on outcomes. RESULTS: 389 KTs were included. Mean donor age was 53.6±15.2 years; 163 (41.9%) came from ECD; mean KDPI was 69.4±23.4%. Median follow-up was 51.9 months. The unadjusted Cox and Kaplan-Meier showed that the three prognostic variables of interest were related to increased risk of patient death, graft failure and death-censored graft failure. However, in the multivariate analysis only KDPI was related to a higher risk of graft failure (HR 1.03 [95% CI 1.01-1.05]; p=0.014). CONCLUSIONS: SCD/ECD classification did not provide significant prognostic information about patient and graft outcomes. KDPI was linearly related to a higher risk of graft failure, providing a better assessment. More studies are needed before using KDPI as a tool to discard or accept kidneys for transplantation.
INTRODUCTION: Kidney donor shortage requires expanding donor selection criteria, as well as use of objective tools to minimize the percentage of discarded organs. Some donor pre-transplant variables such as age, standard/expanded criteria donor (SCD/ECD) definition and calculation of the Kidney Donor Profile Index (KDPI), have demonstrated correlations with patient and graft outcomes. We aimed to establish the accuracy of the three models to determine the prognostic value of kidney transplantation (KT) major outcomes. MATERIAL AND METHODS: We performed a retrospective study in deceased donor KTs at our institution. Unadjusted Cox and Kaplan-Meier survival, and multivariate Cox analyses were fitted to analyze the impact of donor age, SCD/ECD and KDPI on outcomes. RESULTS: 389 KTs were included. Mean donor age was 53.6±15.2 years; 163 (41.9%) came from ECD; mean KDPI was 69.4±23.4%. Median follow-up was 51.9 months. The unadjusted Cox and Kaplan-Meier showed that the three prognostic variables of interest were related to increased risk of patient death, graft failure and death-censored graft failure. However, in the multivariate analysis only KDPI was related to a higher risk of graft failure (HR 1.03 [95% CI 1.01-1.05]; p=0.014). CONCLUSIONS:SCD/ECD classification did not provide significant prognostic information about patient and graft outcomes. KDPI was linearly related to a higher risk of graft failure, providing a better assessment. More studies are needed before using KDPI as a tool to discard or accept kidneys for transplantation.
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: Mehdi Maanaoui; François Provôt; Sébastien Bouyé; Arnaud Lionet; Rémi Lenain; Victor Fages; Marie Frimat; Céline Lebas; François Glowacki; Marc Hazzan Journal: Sci Rep Date: 2021-06-09 Impact factor: 4.379
Authors: Anna Buxeda; Gonzalo Velis; Carlos Arias-Cabrales; Ana Zapatero; Carla Burballa; Dolores Redondo-Pachón; Marisa Mir; Marta Crespo; Julio Pascual; María José Pérez-Sáez Journal: Clin Kidney J Date: 2020-09-10
Authors: Maximilian Dahmen; Felix Becker; Hermann Pavenstädt; Barbara Suwelack; Katharina Schütte-Nütgen; Stefan Reuter Journal: Sci Rep Date: 2019-08-02 Impact factor: 4.379
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