TY - JOUR
T1 - Predictors of Mid-Term Glomerular Filtration Rate after Deceased Donor Renal Transplantation
T2 - Kidney Donor Profile Index as a Predictor of Mid-Term GFR
AU - Andacoglu, Oya M.
AU - Liu, Jack
AU - Brooks, Abigail L.
AU - Blumfield, Amit
AU - Trivedi, Mehul
AU - Lehman, Shoshana
AU - Parides, Michael K.
AU - Akalin, Enver
AU - Graham, Jay A.
AU - Rocca, Juan P.
AU - Greenstein, Stuart M.
N1 - Publisher Copyright:
© 2021 by the author.
PY - 2021
Y1 - 2021
N2 - Glomerular filtration rate (GFR) is an excellent indicator of renal function; however, it is rarely evaluated as an endpoint. We investigated donor and recipient factors for associations that might be predictive of mid-term GFR after renal transplantation. We performed a retrospective review of 828 deceased donor renal transplantations performed at Montefiore Medical Center between the years 2009-2015. Donor characteristics included KDPI, [low (<20%), medium (20-80%), high (>80%)], age, graft types [extended criteria (ECD), cardiac death (DCD), standard criteria (SCD)], CDC high risk, HCV status and cold ischemic time (CIT). Recipient factors included age at transplant, induction agent, BK status, CMV status, acute and chronic rejection, cPRA and DSA status. Primary outcome is 3-year GFR calculated via the MDRD equation. In univariate analysis, donor age, KDPI, ECD, and chronic rejection were significantly associated with changes in 3-year GFR (p<0.001). In the multivariable regression analysis, donor age, KDPI, and chronic rejection remained associated with changes in 3-year GFR (p<0.001). Acute rejection, DCD, HCV status, CIT, BK and CMV viremia, PRA, pretransplant or de novo DSA were not associated with changes in 3-year GFR (p>0.05). We conclude that donor age, KDPI, and chronic rejection are independently associated with 3-year GFR while acute rejection, DCD, HCV status, CIT, BK and CMV viremia, PRA, existing or de novo DSA were not. Based on these findings, current scoring systems may need refinement to address the prognosis of mid-term GFR.
AB - Glomerular filtration rate (GFR) is an excellent indicator of renal function; however, it is rarely evaluated as an endpoint. We investigated donor and recipient factors for associations that might be predictive of mid-term GFR after renal transplantation. We performed a retrospective review of 828 deceased donor renal transplantations performed at Montefiore Medical Center between the years 2009-2015. Donor characteristics included KDPI, [low (<20%), medium (20-80%), high (>80%)], age, graft types [extended criteria (ECD), cardiac death (DCD), standard criteria (SCD)], CDC high risk, HCV status and cold ischemic time (CIT). Recipient factors included age at transplant, induction agent, BK status, CMV status, acute and chronic rejection, cPRA and DSA status. Primary outcome is 3-year GFR calculated via the MDRD equation. In univariate analysis, donor age, KDPI, ECD, and chronic rejection were significantly associated with changes in 3-year GFR (p<0.001). In the multivariable regression analysis, donor age, KDPI, and chronic rejection remained associated with changes in 3-year GFR (p<0.001). Acute rejection, DCD, HCV status, CIT, BK and CMV viremia, PRA, pretransplant or de novo DSA were not associated with changes in 3-year GFR (p>0.05). We conclude that donor age, KDPI, and chronic rejection are independently associated with 3-year GFR while acute rejection, DCD, HCV status, CIT, BK and CMV viremia, PRA, existing or de novo DSA were not. Based on these findings, current scoring systems may need refinement to address the prognosis of mid-term GFR.
KW - Donor renal transplantation
KW - donors and donation
KW - glomerular filtration rate
KW - kidney transplant
KW - recipient survival
KW - risk prediction
KW - risks score
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U2 - 10.21926/obm.transplant.2103150
DO - 10.21926/obm.transplant.2103150
M3 - Article
AN - SCOPUS:85127535856
SN - 2577-5820
VL - 5
JO - OBM Transplantation
JF - OBM Transplantation
IS - 3
ER -