A Comprehensive Risk Quantification Score for Deceased Donor Kidneys: The Kidney Donor Risk Index

Rao, Panduranga S.; Schaubel, Douglas E.; Guidinger, Mary K.; Andreoni, Kenneth A.; Wolfe, Robert A.; Merion, Robert M.; Port, Friedrich K.; Sung, Randall S.

doi:10.1097/tp.0b013e3181ac620b

Cited by 884 publications

(889 citation statements)

References 9 publications

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“…The ECD designation, recipient age, and limited information regarding comorbid disease that is currently collected do not capture all facets of donor and recipient risk. Development and implementation of more sophisticated tools (17) to permit accurate assessment of center-specific outcomes is essential to ensuring the continued expansion of ECD transplantation in the elderly.…”

Section: Discussionmentioning

confidence: 99%

Access to Kidney Transplantation among the Elderly in the United States

Schaeffner¹,

Rose²,

Gill³

2010

Clinical Journal of the American Society of Nephrology

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Section: Discussionmentioning

confidence: 99%

Access to Kidney Transplantation among the Elderly in the United States

Schaeffner¹,

Rose²,

Gill³

2010

Clinical Journal of the American Society of Nephrology

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“…Improved assessment of donor organ quality would also be a useful for planning posttransplant management. Demographic predictive models such as the Kidney Donor Risk Index (KDRI) (11), Schold (12) and Irish scores (13,14) all incorporate donor age, but their actual predictive ability is limited. Histologic assessment is commonly used to predict early dysfunction (15) but once donor age and brain death are taken into account, its predictive ability is poor, in part due to sampling error (16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Comparing Molecular Assessment of Implantation Biopsies With Histologic and Demographic Risk Assessment

Kreepala

Famulski

Chang

et al. 2013

American Journal of Transplantation

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We hypothesized that measurement of previously defined acute kidney injury-induced transcripts at the time of implantation would add a new dimension to existing methods based on donor factors, histology and recipient factors. We analyzed microarray results from implantation biopsies taken after reperfusion from 70 kidneys from 53 deceased donors. We used two definitions of early dysfunction: serum creatinine > 265 umol/L at day 7 posttransplant; and dialysis in the first week. The strongest correlate with early dysfunction was the mean expression of 30 injury transcripts. Older donor and recipient age were associated with early dysfunction, but histologic lesions were not. Prediction was best when the injury transcript expression was combined with donor or recipient age, particularly in standard criteria donors. In contrast, although extended criteria donor kidneys had a high risk of early dysfunction, no variables tested, including injury transcripts, predicted risk significantly, probably because these kidneys were allocated preferentially to old, high risk recipients. The injury transcripts did not predict late function, which was mainly associated with donor age. Thus, measurement of injury-induced transcripts at the time of implantation improves the prediction of early kidney dysfunction, but risk prediction may fail when old kidneys are transplanted into old recipients.

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“…However, as stated in the original paper, this algorithm holds true for (large) patient populations, but has limited value for individual patients. A well established algorithm to assess long-term kidney function after transplantation is the KDRI (26). This algorithm, on the basis of 11 parameters, does not predict short-term kidney function per se, but given the correlation between DGF and poorer prognosis for long-term kidney function, a correlation with DGF may be expected.…”

Section: Discussionmentioning

confidence: 99%

Proteins in Preservation Fluid as Predictors of Delayed Graft Function in Kidneys from Donors after Circulatory Death

Balkom¹,

Gremmels²,

Ooms

et al. 2017

CJASN

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Background and objectives Kidney transplantation is the preferred treatment for ESRD, and donor kidney shortage urges proper donor-recipient matching. Zero-hour biopsies provide predictive values for short-and long-term transplantation outcomes, but are invasive and may not reflect the entire organ. Alternative, more representative methods to predict transplantation outcome are required. We hypothesized that proteins accumulating in preservation fluid during cold ischemic storage can serve as biomarkers to predict posttransplantation graft function. Conclusions We demonstrate that donor kidney preservation fluid harbors biomarkers that, together with information on recipient BMI, predict short-term post-transplantation kidney function. Our approach is safe, easy, and performs better than current prediction algorithms, which are only on the basis of clinical parameters.

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A Comprehensive Risk Quantification Score for Deceased Donor Kidneys: The Kidney Donor Risk Index

Abstract: The graded impact of KDRI on graft outcome makes it a useful decision-making tool at the time of the deceased donor kidney offer.

Cited by 884 publications

References 9 publications

Access to Kidney Transplantation among the Elderly in the United States

Access to Kidney Transplantation among the Elderly in the United States

Comparing Molecular Assessment of Implantation Biopsies With Histologic and Demographic Risk Assessment

Proteins in Preservation Fluid as Predictors of Delayed Graft Function in Kidneys from Donors after Circulatory Death

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