Association of Kidney Donor Risk Index with the Outcome after Kidney Transplantation in the Eurotransplant Senior Program

Abstract

BackgroundWe evaluated the Kidney Donor Risk Index (KDRI) scoring system for kidney transplantation in the Eurotransplant Senior Program (ESP) that allocates kidneys from older donors to older recipients (≥65 years).Material/MethodsWe retrospectively analyzed data of 37 kidney transplant recipients and 36 kidney donors who participated in kidney transplantation program according to the ESP at our center from January 2004 until December 2013.ResultsMean recipient and donor age was 67.9±2.6 and 70.5±4.0 years respectively. The mean KDRI score was 1.7±0.27. Uncensored graft survival after 1 year and 5 years was 64.2% and 53.7% respectively. Subgroup analysis showed that in kidney transplantation with KDRI >1.83, graft survival was significantly reduced compared to lower KDRI subgroups. KDRI was significantly correlated with serum creatinine level at discharge (r=0.4).ConclusionsESP kidneys represent a group of high-risk grafts with high KDRI scores. Higher KDRI scores in ESP kidneys was associated with reduced postoperative short-term and long-term graft outcomes. KDRI might be useful in decision-making for selecting donors for ESP kidney transplantation.

A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation

“…A propensity score matching with caliper of 0.05 was performed based on following variables: donor type (SCD/ECD), CIT, gender and CMV mismatch, number of transplants (first or Re-Tx) and ET-senior program [ 22 ]. The quality of matching was assessed by calculation of the standardized mean difference (SMD) between selected variables, with a SMD < 0.10 reflecting good matching [ 21 ].…”

Transplanting Marginal Organs in the Era of Modern Machine Perfusion and Advanced Organ Monitoring

“…A helpful tool that combines such parameters is the Kidney Donor Risk Index (KDRI), which was generated by weighting the following factors into a single number in order to predict the risk of post-transplant graft failure: age, weight, height, race, history of hypertension, history of diabetes, cause of death, hepatitis C status, serum creatinine, and DCD. The association of KDRI with the outcome in the Eurotransplant senior program (ESP) was evaluated by Schamberger et al (14). Kidney transplantation from Maastricht category-III donors after circulatory death (DCD), which introduces a higher risk of primary non-function and delayed graft function (DGF), has been added to ECD criteria (15).…”

Transplantation of Marginal Organs: Immunological Aspects and Therapeutic Perspectives in Kidney Transplantation

“…This score is currently used in the United States to allocate kidney graft for single kidney transplantation or dual kidney transplantation (94). KDPI score was assessed also in European cohorts of high-risk donorrecipient pairs and was efficient to improve the graft outcome prediction (95).…”