Faculty Collaboration Database

Retroactive application of the new kidney allocation system to renal transplants performed in the ECD/SCD era. Clin Transplant 2015 Dec;29(12):1148-55

Date

10/06/2015

Pubmed ID

26436727

DOI

10.1111/ctr.12642

Scopus ID

2-s2.0-84983209100 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

The kidney allocation system (KAS) aims to improve deceased donor kidney transplant outcomes by matching of donor allografts and kidney recipients using the kidney donor risk index (KDRI) and recipient estimated post-transplant survival (EPTS) indices. In this single-center study, KAS was retroactively applied to 573 adult deceased donor kidney transplants (2004-2012) performed in the extended criteria/standard criteria donor (ECD/SCD) era. Donor KDRI and recipient EPTS were calculated, and transplants were analyzed to identify KAS fits. These were defined as allocation of top 20% allografts to top 20% recipients and bottom 80% allografts to bottom 80% recipients. On retroactive calculation, 70.2% of all transplants fit the KAS. Transplants that fit the KAS had inferior 1- and 5-yr patient survival (95.5% vs. 98.8%, p = 0.048, and 83.4% vs. 91.7%, p = 0.018) and similar 1- and 5-yr graft survival compared to transplants that did not fit the KAS (91.3% vs. 94.1%, p = 0.276, and 72.7% vs. 73.9%, p = 0.561). While EPTS correlated with recipient survival (HR = 2.96, p < 0.001), KDRI correlated with both recipient (HR = 3.56, p < 0.001) and graft survival (HR = 3.23, p < 0.001). Overall, retroactive application of the KAS to transplants performed in the ECD/SCD era did not identify superior patient survival for kidneys allocated in accordance with the KAS.

Author List

Ramanathan R, Gupta G, Kim J, Quinn K, Behnke M, Kang L, Sharma A

Author

Joohyun Kim MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Female
Follow-Up Studies
Glomerular Filtration Rate
Graft Survival
Humans
Kidney Failure, Chronic
Kidney Function Tests
Kidney Transplantation
Male
Middle Aged
Prognosis
Registries
Resource Allocation
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
Tissue Donors
Tissue and Organ Procurement