Systematic review of kidney transplantation functional predictors

Miret-Alomar, E.; Trilla-Herrera, E.; Lorente-Garcia, D.; Regis-Placido, L.; Campo, Rafael; Cuadras-Solé, M.; Pont-Castellana, T.; Moreso-Mateos, F.; Serón-Micas, Daniel; Morote, Juan

doi:10.1016/j.acuroe.2018.03.002

Cited by 2 publications

(2 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, multiple univariable Cox proportional‐hazards regression analyses were performed to individually assess the prospective association of prespecified (literature‐based) established risk factors of graft failure with this outcome 5,22,23 . Hazard ratios (HR) and 95% confidence intervals (CI) were calculated per 1‐SD relative increment (risk factors of continuous nature) or per change compared with the implied reference group (risk factors of categorical nature).…”

Section: Methodsmentioning

confidence: 99%

Urinary liver-type fatty acid-binding protein is independently associated with graft failure in outpatient kidney transplant recipients

Yepes-Calderón

Sotomayor

Pena

et al. 2021

American Journal of Transplantation

View full text Add to dashboard Cite

Urinary liver‐type fatty acid‐binding protein (uL‐FABP) is a biomarker of kidney hypoxia and ischemia, and thus offers a novel approach to identify early kidney insults associated with increased risk of graft failure in outpatient kidney transplant recipients (KTR). We investigated whether uL‐FABP is associated with graft failure and whether it improves risk prediction. We studied a cohort of 638 outpatient KTR with a functional graft ≥1‐year. During a median follow‐up of 5.3 years, 80 KTR developed graft failure. uL‐FABP (median 2.11, interquartile range 0.93–7.37 µg/24"/>h) was prospectively associated with the risk of graft failure (hazard ratio 1.75; 95% confidence interval 1.27–2.41 per 1‐SD increment; P = .001), independent of potential confounders including estimated glomerular filtration rate and proteinuria. uL‐FABP showed excellent discrimination ability for graft failure (c‐statistic of 0.83) and its addition to a prediction model composed by established clinical predictors of graft failure significantly improved the c‐statistic to 0.89 (P for F‐test <.001). These results were robust to several sensitivity analyses. Further validation studies are warranted to evaluate the potential use of a risk‐prediction model including uL‐FABP to improve identification of outpatient KTR at high risk of graft failure in clinical care.

show abstract

Section: Methodsmentioning

confidence: 99%

Urinary liver-type fatty acid-binding protein is independently associated with graft failure in outpatient kidney transplant recipients

Yepes-Calderón

Sotomayor

Pena

et al. 2021

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…Although discard of a small proportion of organs is inevitable, evidence suggests that, in some cases, potentially usable kidneys are being discarded 3,4 . The reasons for discard are multiple, complex, and compounded by a lack of established tools for viability assessment 5,6 . Donor risk indices and pre‐implantation histological scoring have been incorporated into some transplant programs, 7 but lack universal approval, and the latter may even lead to inappropriate discards 8 .…”

Section: Introductionmentioning

confidence: 99%

Macroscopic assessment of the quality of cold perfusion after deceased‐donor kidney procurement: A United Kingdom population‐based cohort study

Dabare

Hodson

Nath

et al. 2021

Clinical Transplantation

View full text Add to dashboard Cite

Concern regarding the quality of cold perfusion (QOP) during macroscopic assessment of procured kidneys is a common reason for discard. In the UK, QOP is routinely graded by both retrieving and implanting teams during back‐bench surgery as: 1 (good), 2 (fair), 3 (poor) or 4 (patchy). We evaluated the association of this grading with organ utilization, graft outcomes, and agreement between teams. Data on all deceased‐donor kidneys procured between January 2000 and December 2016 were analyzed for discard rates, while association with graft outcomes was studied in single adult transplants. Of 31,167 kidneys procured, 90.6%, 5.7%, 1.7%, and 2.1% were assigned grades 1, 2, 3, and 4, respectively, at retrieval. QOP was an independent risk factor of discard, with the highest rates observed in grade 3 kidneys (41.8%), compared to 6.5% in grade 1 (aOR 7.67, 95% CI 5.44–10.82, p < .001). Grading at retrieval was an independent predictor of delayed graft function (p = .019) and primary non‐function (p = .001), but not long‐term graft survival (p = .111). Implanting grade was an independent predictor of all three outcomes (p < .001, p < .001, and p = .002, respectively). Consistency of grading between teams was poor (Kappa = 0.179). QOP influences utilization and predicts outcomes, but a standardized and validated scoring system is required.

show abstract

Systematic review of kidney transplantation functional predictors

Cited by 2 publications

References 36 publications

Urinary liver-type fatty acid-binding protein is independently associated with graft failure in outpatient kidney transplant recipients

Urinary liver-type fatty acid-binding protein is independently associated with graft failure in outpatient kidney transplant recipients

Macroscopic assessment of the quality of cold perfusion after deceased‐donor kidney procurement: A United Kingdom population‐based cohort study

Contact Info

Product

Resources

About