Heungman Jun1, Hye Eun Yoon2, Kang Wook Lee3, Dong Ryeol Lee4, Jaeseok Yang5, Curie Ahn6, Sang Youb Han7. 1. Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea. 2. Department of Internal Medicine, Incheon St. Mary's Hospital, the Catholic University of Korea, College of Medicine, Incheon, Korea. 3. Department of Nephrology, Chungnam National University Hospital, Daejeon, Korea. 4. Division of Nephrology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea. 5. Department of Surgery, Transplantation Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. 6. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. 7. Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea. Electronic address: hansy@paik.ac.kr.
Abstract
BACKGROUND: It is unclear whether both Kidney Donor Profile Index (KDPI) and Kidney Donor Risk Index (KDRI) scores can be applied to elderly deceased donors (DDs). This study aimed to compare the predictive values of KDRI and KDPI for the occurrence of delayed graft function (DGF) in kidney transplantation (KT) from elderly DDs. METHODS: The data for 1049 DD KTs from the database of the Korean Organ Transplant Registry were reviewed retrospectively. RESULTS: The mean age of the 1049 DDs was 50.94 ± 10.57 years. A total of 224 DDs were ≥60 years old (21.35%). The mean KDRI and KDPI were 1.24 ± 0.40 and 63.58 ± 25.16, respectively. Ninety (8.6%) recipients had DGF postoperatively. The right-skewed distributions of KDRI in both elderly and nonelderly DDs were similar. However, the KDPI curve showed a sharp increase from a KDPI score of 60 in DDs aged ≥60 years. The areas under the curve (AUCs) of receiver operator characteristics (ROC) for KDPI and KDRI were different. In DDs aged <60 years, the estimated AUCs of ROC showed significant values for KDPI (0.577, 95% confidence interval, 0.503-0.637; P = .048) and KDRI (0.576, 0.505-0.639; P = .043). However, in DDs aged ≥60 years, KDRI score, not KDPI, was a significant value: KDRI, 0.633 (0.498-0.767; P = .034); KDPI, 0.530 (0.476-0.643; P = .138). CONCLUSION: KDRI was more reliable in predicting graft outcome than KDPI in KT from elderly DDs. A longer follow-up period is needed to assess predictors for postoperative renal functions.
BACKGROUND: It is unclear whether both Kidney Donor Profile Index (KDPI) and Kidney Donor Risk Index (KDRI) scores can be applied to elderly deceased donors (DDs). This study aimed to compare the predictive values of KDRI and KDPI for the occurrence of delayed graft function (DGF) in kidney transplantation (KT) from elderly DDs. METHODS: The data for 1049 DD KTs from the database of the Korean Organ Transplant Registry were reviewed retrospectively. RESULTS: The mean age of the 1049 DDs was 50.94 ± 10.57 years. A total of 224 DDs were ≥60 years old (21.35%). The mean KDRI and KDPI were 1.24 ± 0.40 and 63.58 ± 25.16, respectively. Ninety (8.6%) recipients had DGF postoperatively. The right-skewed distributions of KDRI in both elderly and nonelderly DDs were similar. However, the KDPI curve showed a sharp increase from a KDPI score of 60 in DDs aged ≥60 years. The areas under the curve (AUCs) of receiver operator characteristics (ROC) for KDPI and KDRI were different. In DDs aged <60 years, the estimated AUCs of ROC showed significant values for KDPI (0.577, 95% confidence interval, 0.503-0.637; P = .048) and KDRI (0.576, 0.505-0.639; P = .043). However, in DDs aged ≥60 years, KDRI score, not KDPI, was a significant value: KDRI, 0.633 (0.498-0.767; P = .034); KDPI, 0.530 (0.476-0.643; P = .138). CONCLUSION: KDRI was more reliable in predicting graft outcome than KDPI in KT from elderly DDs. A longer follow-up period is needed to assess predictors for postoperative renal functions.