Validación del KDRI/KPDI para la selección de donantes renales con criterios expandidos

Introduction: Kidney Donor Profile Index (KDPI) has been incorporated in the United States to improve the kidney transplant allocation system. Objectives: To evaluate deceased kidney donors’ profile using KDPI and compare to the previous United Network for Organ Sharing (UNOS) definition of expanded criteria donors (ECD) and assess the KDPI applicability to predict five-year graft survival and renal function in our sample. Methods: Retrospective cohort of 589 kidney transplants from deceased donors performed from January 2009 to May 2013 with follow-up until May 2018. Results: In 589 kidney transplants, 36.6% of donors were classified as ECD and 28.8% had KDPI ≥ 85%. Mean KDPI was 63.1 (95%CI: 60.8-65.3). There was an overlap of standard and ECD in KDPI between 60 and 95 and a significantly lower death-censored graft survival in KDPI ≥ 85% (78.6%); KDPI 0-20: 89.8%, KDPI 21-59: 91.6%, and KDPI 60-84: 83.0%; p = 0.006. The AUC-ROC was 0.577 (95%CI: 0.514-0.641; p = 0.027). Renal function at 5 years was significantly lower according to the incremental KDPI (p < 0.002). KDPI (HR 1.011; 95%CI 1.001-1.020; p = 0.008), donor-specific antibodies (HR 2.77; 95%CI 1.69-4.54; p < 0.001), acute rejection episode (HR 1.73; 95%CI 1.04-2.86; p = 0.034) were independent and significant risk factors for death-censored graft loss at 5 years. Conclusion: In our study, 36.6% were classified as ECD and 28.8% had KDPI ≥ 85%. KDPI score showed a moderate power to predict graft survival at 5 years. Renal function was significantly lower in patients with higher KDPI.

show abstract

“…The KDRI has already been validated in the Dutch population 28 . In Spain, the KDPI and KDRI were validated for ECDs 29 .…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Kidney Donor Profile Index (KDPI) to predict graft survival in a South Brazilian Cohort

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In our study, the KDRI better represented DGF than KDPI in KT from DDs �60 years. A previous report indicated that the KDRI was better than the KDPI in estimating graft survival [18]. The KDPI is a relative mapping of the KDRI.…”

Section: Plos Onementioning

confidence: 99%

Outcomes of kidney transplantation from elderly deceased donors of a Korean registry

Jun

Kim

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Recently, a Spanish study validated the usefulness of the KDRI in a European population[77]. The study evaluated 144 renal transplants.…”

Section: Ecd-kdri-kdpimentioning

confidence: 99%

Histological and clinical evaluation of marginal donor kidneys before transplantation: Which is best?

Salvadori¹,

Tsalouchos²

2019

WJT

View full text Add to dashboard Cite

Organ shortage represents one of the major limitations to the development of kidney transplantation. To increase the donor pool and to answer the ever increasing kidney request, physicians are recurring to marginal kidneys as kidneys from older donors, from hypertensive or diabetic donors and from non-heart beating donors. These kidneys are known to have frequently a worse outcome in the recipients. To date major problem is to evaluate such kidneys in order to use or to discard them before transplantation. The use of such kidneys create other relevant question as whether to use them as single or dual transplant and to allocate them fairly according transplant programs. The pre-transplant histological evaluation, the clinical evaluation of the donor or both the criteria joined has been used and according the time each criterion prevailed over the others. Aim of this review has been to examine the advantages and the drawbacks of any criterion and how they have changed with time. To date any criterion has several limitations and several authors have argued for the development of new guidelines in the field of the kidney evaluation for transplantation. Several authors argue that the use of omic technologies should improve the organ evaluation and studies are ongoing to evaluate these technologies either in the donor urine or in the biopsies taken before transplantation.

show abstract

Validación del KDRI/KPDI para la selección de donantes renales con criterios expandidos

Cited by 8 publications

References 18 publications

Usefulness of Kidney Donor Profile Index (KDPI) to predict graft survival in a South Brazilian Cohort

Usefulness of Kidney Donor Profile Index (KDPI) to predict graft survival in a South Brazilian Cohort

Outcomes of kidney transplantation from elderly deceased donors of a Korean registry

Histological and clinical evaluation of marginal donor kidneys before transplantation: Which is best?

Contact Info

Product

Resources

About