Philip A Clayton1,2,3, Kathryn Dansie1, Matthew P Sypek1,4,5, Sarah White6, Steve Chadban1,6,7, John Kanellis8,9, Peter Hughes4,5, Aarti Gulyani1, Stephen McDonald1,2,3. 1. Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, SA, Australia. 2. Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, Australia. 3. Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia. 4. Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VC, Australia. 5. Department of Nephrology, Royal Melbourne Hospital, Melbourne, VC, Australia. 6. Kidney Node, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia. 7. Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia. 8. Department of Nephrology, Monash, Health, Melbourne, VC, Australia. 9. Department of Medicine, Centre for Inflammatory Diseases, Monash University, Melbourne, NSW, Australia.
Abstract
BACKGROUND: The US Kidney Donor Risk Index (KDRI) and the UK KDRI were developed to estimate the risk of graft failure following kidney transplantation. Neither score has been validated in the Australian and New Zealand (ANZ) population. METHODS: Using data from the Australia and New Zealand Organ Donor (ANZOD) and Dialysis and Transplant (ANZDATA) Registries, we included all adult deceased donor kidney-only transplants performed in ANZ from 2005 to 2016 (n = 6405). The KDRI was calculated using both the US donor-only and UK formulae. Three Cox models were constructed (Model 1: KDRI only; Model 2: Model 1 + transplant characteristics; Model 3: Model 2 + recipient characteristics) and compared using Harrell's C-statistics for the outcomes of death-censored graft survival and overall graft survival. RESULTS: Both scores were strongly associated with death-censored and overall graft survival (P < 0.0001 in all models). In the KDRI-only models, discrimination of death-censored graft survival was moderately good with C-statistics of 0.63 and 0.59 for the US and UK scores, respectively. Adjusting for transplant characteristics resulted in marginal improvements of the US KDRI to 0.65 and the UK KDRI to 0.63. The addition of recipient characteristics again resulted in marginal improvements of the US KDRI to 0.70 and the UK KDRI to 0.68. Similar trends were seen for the discrimination of overall graft survival. CONCLUSIONS: The US and UK KDRI scores were moderately good at discriminating death-censored and overall graft survival in the ANZ population, with the US score performing slightly better in all models.
BACKGROUND: The US Kidney Donor Risk Index (KDRI) and the UK KDRI were developed to estimate the risk of graft failure following kidney transplantation. Neither score has been validated in the Australian and New Zealand (ANZ) population. METHODS: Using data from the Australia and New Zealand Organ Donor (ANZOD) and Dialysis and Transplant (ANZDATA) Registries, we included all adult deceased donor kidney-only transplants performed in ANZ from 2005 to 2016 (n = 6405). The KDRI was calculated using both the US donor-only and UK formulae. Three Cox models were constructed (Model 1: KDRI only; Model 2: Model 1 + transplant characteristics; Model 3: Model 2 + recipient characteristics) and compared using Harrell's C-statistics for the outcomes of death-censored graft survival and overall graft survival. RESULTS: Both scores were strongly associated with death-censored and overall graft survival (P < 0.0001 in all models). In the KDRI-only models, discrimination of death-censored graft survival was moderately good with C-statistics of 0.63 and 0.59 for the US and UK scores, respectively. Adjusting for transplant characteristics resulted in marginal improvements of the US KDRI to 0.65 and the UK KDRI to 0.63. The addition of recipient characteristics again resulted in marginal improvements of the US KDRI to 0.70 and the UK KDRI to 0.68. Similar trends were seen for the discrimination of overall graft survival. CONCLUSIONS: The US and UK KDRI scores were moderately good at discriminating death-censored and overall graft survival in the ANZ population, with the US score performing slightly better in all models.
Authors: Alexander F Schaapherder; Maria Kaisar; Lisa Mumford; Matthew Robb; Rachel Johnson; Michèle J C de Kok; Frederike J Bemelman; Jacqueline van de Wetering; Arjan D van Zuilen; Maarten H L Christiaans; Marije C Baas; Azam S Nurmohamed; Stefan P Berger; Esther Bastiaannet; Aiko P J de Vries; Edward Sharples; Rutger J Ploeg; Jan H N Lindeman Journal: EClinicalMedicine Date: 2022-06-25
Authors: Michael G Collins; Magid A Fahim; Elaine M Pascoe; Kathryn B Dansie; Carmel M Hawley; Philip A Clayton; Kirsten Howard; David W Johnson; Colin J McArthur; Rachael C McConnochie; Peter F Mount; Donna Reidlinger; Laura Robison; Julie Varghese; Liza A Vergara; Laurence Weinberg; Steven J Chadban Journal: Trials Date: 2020-05-25 Impact factor: 2.279
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Authors: Nicholas G Larkins; Germaine Wong; David W Johnson; Carmel Hawley; Armando Teixeira-Pinto; Henry Pleass; Helen Pilmore; Wai H Lim Journal: Transplant Direct Date: 2021-10-22
Authors: Wai H Lim; Esther Ooi; Helen L Pilmore; David W Johnson; Stephen P McDonald; Philip Clayton; Carmel Hawley; William R Mulley; Ross Francis; Michael G Collins; Bryon Jaques; Nicholas G Larkins; Christopher E Davies; Kate Wyburn; Steve J Chadban; Germaine Wong Journal: Transpl Int Date: 2022-02-07 Impact factor: 3.782
Authors: Sameera Senanayake; Sanjeewa Kularatna; Helen Healy; Nicholas Graves; Keshwar Baboolal; Matthew P Sypek; Adrian Barnett Journal: BMC Med Res Methodol Date: 2021-06-21 Impact factor: 4.615