M.F.J. Heide, H.J.W. de Fijter, L.G.M. Wijermars, H. Putter, A.F.M. Schaapherder, V.A.L. Huurman
Chair(s): prof. dr. Irma Joosten, immunoloog, radboudumc, Nijmegen
Thursday 10 march 2016
13:30 - 14:00h at Foyer
Parallel session: Postersessies XI - Opgesplitst in 3 tijdblokken en 3 categoriëen (klinisch, basaal, donatie)
Assessment of the Kidney Donor Risk Index (KDRI) to predict graft failure in a Dutch deceased donor kidney transplant cohort. The Kidney Donor Risk Index (KDRI) was introduced in 2010 by the OPTN network in the United States to optimize the number of life years lived with a donor kidney. This index is calculated from a formula including 10 factors: donor age, height, weight, ethnicity, hypertension, diabetes, cause of death, serum creatinine, Hepatitis C status and type of donation (DBD or DCD). Since differences exist between the US and Europe regarding donor population and organ allocation protocols, we decided to evaluate the predictive value of the KDRI for graft failure in a recent European cohort of kidney transplant recipients. A retrospective analysis was performed on the association of KDRI donor risk factors with graft failure in 515 deceased donor kidney transplants, performed at our center between 2007 and 2015. Primary outcome measure was graft failure, defined as return to dialysis or death. All risk factors, except ethnicity and HCV status were available for analysis to compute the KDRI. The KDRI as a whole significantly predicted graft failure in our patient cohort (p=0,004). When analyzing the relative contribution of each KDRI parameter by multivariate analysis, only donor age proved to be a significant contributor to graft failure (p<0,001; HR=1,033; 95% CI 1,016-1,051) as well as patient survival (p<0,001; HR=1,042; 95% CI 1,022-1,062).A trend was observed towards poorer patient survival after DCD kidney donation (p=0.15). In this analysis ,donor age was the only significant KDRI factor contributing to graft loss in the investigated Leiden kidney transplant cohort. This may be related to the number of patients included. Larger study populations are now investigated to identify additional significant parameters. These studies may also aid in developing a risk index to predict outcome in a European kidney transplant recipient population that should include not just donor, but also recipient and transplant-related factors.