Kidney donor risk index is a good prognostic tool for graft outcomes in deceased donor kidney transplantation with short, cold ischemic time. (8th February 2014)

• Record Type: Journal Article
• Authors: Han, Miyeun; Jeong, Jong Cheol; Koo, Tai Yeon; Jeon, Hee Jung; Kwon, Hyuk Yong; Kim, Yoon Jung; Ryu, Hyun Jin; Ahn, Curie; Yang, Jaeseok
• Is Part Of: Clinical transplantation. Volume 28:Number 3(2014:May/Jun.)
• Page Start: 337
• Page End: 344
• Publication Date: 2014-02-08
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12318
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12318-abs-0001"> <title>Abstract</title> <sec id="ctr12318-sec-0001" sec-type="section"> <title>Background</title> <p>We performed a retrospective cohort study to determine the prognostic value of standard criteria donor/expanded criteria donor (SCD/ECD) designation, with regard to one‐yr GFR and graft survival rate, in a region with short, cold ischemic time (CIT), and how this designation compares with the kidney donor risk index (KDRI) and zero‐time kidney biopsies.</p> </sec> <sec id="ctr12318-sec-0002" sec-type="section"> <title>Methods</title> <p>We reviewed 362 cases of deceased donor kidney transplantation (DDKT). Donor kidneys were classified as SCD or ECD. They were also assessed by the KDRI. Zero‐time kidney biopsy was performed in 196 patients, and histologic score was assessed.</p> </sec> <sec id="ctr12318-sec-0003" sec-type="section"> <title>Results</title> <p>Median follow‐up duration was 46 months. Forty‐two cases (11.6%) used ECD kidneys. The mean CIT was only 4.9 ± 2.7 h. Graft survival rates were not significantly different between ECD and SCD groups. The KDRI showed the best correlation with one‐yr estimations of glomerular filtration rate (eGFR) (<italic>R</italic><sup>2</sup> = 0.230, p < 0.001), and higher KDRI was associated with a higher risk of graft failure (hazard ratio 2.63, 95% confidence interval 1.01–6.87). However, higher histologic score was not associated with a higher risk of graft failure.</p> </sec> <sec id="ctr12318-sec-0004" sec-type="section"> <title>Conclusion</title> <p>KDRI has greater predictive value for short‐term outcomes in DDKT with short CIT than the SCD/ECD designation or pathology.</p> </sec> </abstract>