Kidney donor risk index is a good prognostic tool for graft outcomes in deceased donor kidney transplantation with short, cold ischemic time

• DOI: 10.1111/ctr.12318
• Publication Date: 2014-02-08T08:58:54Z
• Authors: Miyeun Han; Jong Cheol Jeong; Tai Yeon Koo; Hee Jung Jeon; Hyuk Yong Kwon; Yoon Jung Kim; Hyun Jin Ryu; Curie Ahn; Jaeseok Yang
• Keywords: Adult; Graft Rejection; Male; Tissue and Organ Procurement; Cold Ischemia; Graft Survival; Middle Aged; Prognosis; Kidney Transplantation; Risk Assessment; Tissue Donors; 3. Good health; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Cadaver; Humans; Kidney Failure, Chronic; Female; Follow-Up Studies; Retrospective Studies

AbstractBackgroundWe performed a retrospective cohort study to determine the prognostic value of standard criteria donor/expanded criteria donor (SCD/ECD) designation, with regard to one‐yr GFR and graft survival rate, in a region with short, cold ischemic time (CIT), and how this designation compares with the kidney donor risk index (KDRI) and zero‐time kidney biopsies.MethodsWe reviewed 362 cases of deceased donor kidney transplantation (DDKT). Donor kidneys were classified as SCD or ECD. They were also assessed by the KDRI. Zero‐time kidney biopsy was performed in 196 patients, and histologic score was assessed.ResultsMedian follow‐up duration was 46 months. Forty‐two cases (11.6%) used ECD kidneys. The mean CIT was only 4.9 ± 2.7 h. Graft survival rates were not significantly different between ECD and SCD groups. The KDRI showed the best correlation with one‐yr estimations of glomerular filtration rate (eGFR) (R2 = 0.230, p < 0.001), and higher KDRI was associated with a higher risk of graft failure (hazard ratio 2.63, 95% confidence interval 1.01–6.87). However, higher histologic score was not associated with a higher risk of graft failure.ConclusionKDRI has greater predictive value for short‐term outcomes in DDKT with short CIT than the SCD/ECD designation or pathology.