Analysis of Distribution of Expanded- and Standard-Criteria Donors and Complications Among Polish Recipients by Kidney Donor Risk Index Value

Serwańska-Świętek, Marta; Wszoła, Michał; Domagała, Piotr; Berman, Andrzej; Bieniasz, M.; Kieszek, R.; Karpeta, Edyta; Górski, Łukasz; Kwapisz, Magdalena; Ostaszewska, Agata; Sobol, Maria; Bednarska, Karolina; Gniewkiewicz, Michał; Perkowska‐Ptasińska, Agnieszka; Dęborska−Materkowska, Dominika; Gozdowska, Jolanta; Durlik, Magdalena; Chmura, A.; Kwiatkowski, A.

doi:10.1016/j.transproceed.2018.02.132

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…A study by Serwanska-Swietek et al . [ 12 ] showed that graft function as assessed by estimated glomerular filtration rate (eGFR) after 1 year in ECD recipients was significantly different according to KDRI scores, with lower KDRI values corresponding with better outcomes. This study suggests that KDRI may facilitate the improvement of the kidney allocation system in Poland as well, but further research with a longer follow-up period is needed.…”

Section: Introductionmentioning

confidence: 99%

Association between Kidney Donor Risk Index, kidney graft function and histological changes in early post-transplant graft biopsy

Słabiak-Błaż

Kujawa-Szewieczek

Kolonko

et al. 2023

Clinical Kidney Journal

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Background Proper assessment of donor organ quality is crucial for optimal kidney allocation and best long-term outcomes. The aim of this study was to analyze the association between the Kidney Donor Risk Index (KDRI) and histological parameters in early post-transplant graft biopsy in Polish cohort of kidney transplant recipients (KTRs). Methods In 418 consecutive KTRs, a histological evaluation of very early (at median 11 (9–13) post-transplant day) protocol core needle biopsy was performed and analyzed according to the Banff classification. Subjects were divided into quartiles (Q) of the KDRI value. Kidney graft function, patient and graft survival were also analyzed over a median follow-up period of 44 (26–56) months. Results There was a significant trend toward greater intensity of chronic histology changes along the KDRI quartiles (χ2 = 20.8; p < 0.001), including interstitial fibrosis, tubular atrophy, mesangial matrix increase and arteriolar hyalinosis. Stepwise multivariate regression analysis revealed that only higher KDRI value independently increased the severity of chronic graft injury (rpartial = 0.340, p < 0.001). KDRI values were valuable in the determination of both early and long-term graft function. Conclusion The KDRI values correlates with chronic histological changes found in early post-implantation kidney biopsies and can also be helpful in the prediction of graft outcome.

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Section: Introductionmentioning

confidence: 99%

Association between Kidney Donor Risk Index, kidney graft function and histological changes in early post-transplant graft biopsy

Słabiak-Błaż

Kujawa-Szewieczek

Kolonko

et al. 2023

Clinical Kidney Journal

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“…6 Higher KDPI (lower-quality) kidneys are associated with increased risks of graft failure, return to dialysis, and posttransplantation expenses. 7,8 Higher rates of graft failure have health and economic consequences to patients, as well as economic consequences to health systems. The cost-effectiveness, however, is thought to be superior to continuing dialysis.…”

Section: Introductionmentioning

confidence: 99%

Donor Kidney Quality and Transplant Outcome: An Economic Evaluation of Contemporary Practice

et al. 2020

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Time-to-event analysis in economic evaluations: a comparison of modelling methods to assess the cost-effectiveness of transplanting a marginal quality kidney

et al. 2021

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Background Economic-evaluations using decision analytic models such as Markov-models (MM), and discrete-event-simulations (DES) are high value adds in allocating resources. The choice of modelling method is critical because an inappropriate model yields results that could lead to flawed decision making. The aim of this study was to compare cost-effectiveness when MM and DES were used to model results of transplanting a lower-quality kidney versus remaining waitlisted for a kidney. Methods Cost-effectiveness was assessed using MM and DES. We used parametric survival models to estimate the time-dependent transition probabilities of MM and distribution of time-to-event in DES. MMs were simulated in 12 and 6 monthly cycles, out to five and 20-year time horizon. Results DES model output had a close fit to the actual data. Irrespective of the modelling method, the cycle length of MM or the time horizon, transplanting a low-quality kidney as compared to remaining waitlisted was the dominant strategy. However, there were discrepancies in costs, effectiveness and net monetary benefit (NMB) among different modelling methods. The incremental NMB of the MM in the 6-months cycle lengths was a closer fit to the incremental NMB of the DES. The gap in the fit of the two cycle lengths to DES output reduced as the time horizon increased. Conclusion Different modelling methods were unlikely to influence the decision to accept a lower quality kidney transplant or remain waitlisted on dialysis. Both models produced similar results when time-dependant transition probabilities are used, most notable with shorter cycle lengths and longer time-horizons.

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Analysis of Distribution of Expanded- and Standard-Criteria Donors and Complications Among Polish Recipients by Kidney Donor Risk Index Value

Cited by 3 publications

References 19 publications

Association between Kidney Donor Risk Index, kidney graft function and histological changes in early post-transplant graft biopsy

Association between Kidney Donor Risk Index, kidney graft function and histological changes in early post-transplant graft biopsy

Donor Kidney Quality and Transplant Outcome: An Economic Evaluation of Contemporary Practice

Time-to-event analysis in economic evaluations: a comparison of modelling methods to assess the cost-effectiveness of transplanting a marginal quality kidney

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