Function and longevity of renal grafts from high-KDPI donors.
kidney donor profile index
renal transplantation
Journal
Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
01
06
2022
received:
22
12
2021
accepted:
09
06
2022
pubmed:
2
7
2022
medline:
21
9
2022
entrez:
1
7
2022
Statut:
ppublish
Résumé
High kidney-donor profile index (KDPI) kidneys have a shorter survival than grafts with lower KDPI values. It is still unclear, however, whether their shorter longevity depends on an inferior baseline function, faster functional decline, or the combination of both. We analyzed the estimated glomerular filtration rate (eGFR) of 605 consecutive recipients of deceased donor kidney transplants (KT) at 1, 3, 6, 12, 18, 24, 36, 48, and 60 months. Comparisons were performed among four groups based on KDPI quartile: Group I-KDPI ≤ 25% (n = 151), Group II-KDPI 26-50% (n = 182), Group III-KDPI 51-75% (n = 176), and Group IV-KDPI 〉 75% (n = 96). Linear mixed model analysis was subsequently used to assess whether KDPI was independently associated with the decline in eGFR during the first 5-years after KT. We also analyzed the incidence of delayed graft function (DGF), rejection within the first year after KT, patient survival, graft survival, and death censored graft survival based on KDPI group. High-KDPI grafts had lower eGFR immediately after KT, had a higher incidence of DGF and rejection. However, there were no signifcant differences in the adjusted rate (slope) of decline in eGFR among the four KDPI groups (P = .06). Although patient survival was signigicantly lower for recipients of high-KDPI grafts, death-censored graft survival was similar among the four KDPI groups (P = .33). The shorter functional survival of high-KDPI grafts seems to be due to their lower baseline eGFR rather than a more rapid functional decline after KT.
Sections du résumé
BACKGROUND
High kidney-donor profile index (KDPI) kidneys have a shorter survival than grafts with lower KDPI values. It is still unclear, however, whether their shorter longevity depends on an inferior baseline function, faster functional decline, or the combination of both.
METHODS
We analyzed the estimated glomerular filtration rate (eGFR) of 605 consecutive recipients of deceased donor kidney transplants (KT) at 1, 3, 6, 12, 18, 24, 36, 48, and 60 months. Comparisons were performed among four groups based on KDPI quartile: Group I-KDPI ≤ 25% (n = 151), Group II-KDPI 26-50% (n = 182), Group III-KDPI 51-75% (n = 176), and Group IV-KDPI 〉 75% (n = 96). Linear mixed model analysis was subsequently used to assess whether KDPI was independently associated with the decline in eGFR during the first 5-years after KT. We also analyzed the incidence of delayed graft function (DGF), rejection within the first year after KT, patient survival, graft survival, and death censored graft survival based on KDPI group.
FINDINGS
High-KDPI grafts had lower eGFR immediately after KT, had a higher incidence of DGF and rejection. However, there were no signifcant differences in the adjusted rate (slope) of decline in eGFR among the four KDPI groups (P = .06). Although patient survival was signigicantly lower for recipients of high-KDPI grafts, death-censored graft survival was similar among the four KDPI groups (P = .33).
CONCLUSIONS
The shorter functional survival of high-KDPI grafts seems to be due to their lower baseline eGFR rather than a more rapid functional decline after KT.
Identifiants
pubmed: 35778369
doi: 10.1111/ctr.14759
pmc: PMC9786736
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14759Informations de copyright
© 2022 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd.
Références
Transplantation. 2002 Nov 27;74(10):1377-81
pubmed: 12451234
J Clin Invest. 1955 Feb;34(2):327-82
pubmed: 13233354
Am J Transplant. 2014 Aug;14(8):1922-6
pubmed: 24903739
N Engl J Med. 1999 Dec 2;341(23):1725-30
pubmed: 10580071
Kidney Int. 2004 Jan;65(1):289-97
pubmed: 14675062
Age Ageing. 2007 Nov;36(6):689-92
pubmed: 17881417
Metabolism. 2006 Jan;55(1):108-12
pubmed: 16324928
Nephrol Dial Transplant. 2008 Sep;23(9):2995-3003
pubmed: 18408075
Am J Kidney Dis. 2014 Feb;63(2):244-50
pubmed: 24210590
Transplantation. 2019 Jul;103(7):1457-1467
pubmed: 30747837
Am J Transplant. 2021 Feb;21 Suppl 2:21-137
pubmed: 33595191
Sci Rep. 2019 Aug 2;9(1):11234
pubmed: 31375750
Saudi J Kidney Dis Transpl. 2009 Jan;20(1):86-90
pubmed: 19112223
Am J Transplant. 2018 Jul;18(7):1710-1717
pubmed: 29247472
Am J Transplant. 2018 Feb;18(2):293-307
pubmed: 29243394
Transplantation. 1997 Dec 27;64(12):1748-54
pubmed: 9422415
BJOG. 2008 Jan;115(1):109-12
pubmed: 17970797
Ren Fail. 2008;30(4):345-52
pubmed: 18569905
Nephrol Dial Transplant. 2011 Sep;26(9):2780-5
pubmed: 21357214
N Engl J Med. 2021 Aug 19;385(8):729-743
pubmed: 34407344
Lancet. 2007 Oct 20;370(9596):1453-7
pubmed: 18064739
Transplantation. 2009 Jul 27;88(2):231-6
pubmed: 19623019
Nephrol Dial Transplant. 2012 Apr;27(4):1663-71
pubmed: 21926404
Nephrol Dial Transplant. 2018 Aug 1;33(8):1465-1472
pubmed: 29617898
Pathology. 2009;41(4):379-82
pubmed: 19404852
Clin Transplant. 2022 Sep;36(9):e14759
pubmed: 35778369
Am J Transplant. 2021 Mar;21(3):1160-1170
pubmed: 32594613
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Am J Transplant. 2013 Apr;13(4):1001-1011
pubmed: 23406350
Transplant Proc. 2017 Jan - Feb;49(1):88-91
pubmed: 28104166
Am J Transplant. 2016 Jul;16(7):2202-7
pubmed: 26932575
Gac Med Mex. 2001 Jul-Aug;137(4):387-90
pubmed: 11519365
JAMA. 2014 Jun 25;311(24):2518-2531
pubmed: 24892770
Scand J Clin Lab Invest Suppl. 2008;241:39-45
pubmed: 18569963
Am J Transplant. 2017 Oct;17(10):2696-2704
pubmed: 28556492
Am J Transplant. 2014 Feb;14(2):272-83
pubmed: 24472190
Transplantation. 2007 Dec 27;84(12):1618-24
pubmed: 18165773