Donor risk scores: can they predict renal transplant outcomes?

Huang, Edmund; Danovitch, Gabriel M.; Bunnapradist, Suphamai

doi:10.1038/nrneph.2011.39

Cited by 2 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Deceased donors are classified as ECD based on an algorithm that takes into account four characteristics: age, cause of death, history of hypertension, and renal dysfunction [2,3]. In order to grade the spectrum of ECD quality, different studies have explored the predictive value of histological versus clinical scoring systems [4,5,6]. The evaluation criteria of pre-implantation biopsies arise from a quantitative assessment of the lesions in different renal compartments, namely vascular intimal sclerosis, tubular atrophy, interstitial fibrosis, interstitial inflammation, mesangial matrix increase and glomerular sclerosis [7,8].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Three-Year Outcome of Renal Transplantation from Optimal Donors versus Expanded Criteria Donors

Manna¹,

Comai²,

Cappuccilli³

et al. 2013

Am J Nephrol

View full text Add to dashboard Cite

Background/Aims: The shortage in organ supply has required the use of expanded criteria donors (ECD) for kidney transplantation. Current pre-transplant evaluations of ECD organs are based on histological, clinical or mixed criteria. This monocentric study investigates the predictivity of Karpinski’s histological score on 3-year graft function in renal transplant. Ex-post classification using Nyberg’s score was carried out to assess the reliability of a purely clinical score and its applicability for organ allocation. Methods: We evaluated 407 deceased donors (251 optimal and 156 ECD) for renal transplants performed between 2001 and 2006. The differences in creatinine levels and MDRD-GFR at transplant and 1, 2 and 3 years post-transplant between optimal donors and ECD were recorded. Amongst ECD organs, the effect of different Karpinski score classes (0–1, 2, 3, 4, double transplants) on 3-year graft outcomes was analyzed. We then compared renal function over time across the Nyberg grades (A, B, C, and D). Results: Karpinski scores 0–1 and 2 and double transplants were associated with improved graft function compared to scores 3 and 4. Nyberg’s clinical score shows a good fit with medium-term outcome and Karpinski’s score, but among the donors with a high Nyberg grade (C and D), it fails to differentiate between allocable or non-allocable organs (due to Karpinski’s score ≥7). Conclusions: Our data demonstrate a correlation of histological damage at the time of transplant with 3-year graft function, but at present we are unable to provide any supposition on the possible outcome of the discarded kidneys.

show abstract

Section: Introductionmentioning

confidence: 99%

Prediction of Three-Year Outcome of Renal Transplantation from Optimal Donors versus Expanded Criteria Donors

Manna¹,

Comai²,

Cappuccilli³

et al. 2013

Am J Nephrol

View full text Add to dashboard Cite

show abstract

“…Various tools to aid decision-making are currently available or under investigation. These include donor risk scores in the setting of DCD kidneys ( 85 ), donor-recipient characteristics ( 86 ), donor-specific features ( 87 ), monitoring of perfusion parameters and assessment of tissue viability function ex situ ( 88 ), molecular diagnostics ( 89 ), and machine learning and artificial intelligence (AI) algorithms ( 90 - 92 ). The latter remains in its infancy, with tremendous potential to augment the decision-making regarding transplantation ( 93 ), but requires more granular data, generalizability, and validation across different population cohorts to enter mainstream use.…”

Section: Decision Challengesmentioning

confidence: 99%

Deceased Donor Characteristics and Kidney Transplant Outcomes

Sharif

2022

Transpl Int

View full text Add to dashboard Cite

Kidney transplantation is the therapy of choice for people living with kidney failure who are suitable for surgery. However, the disparity between supply versus demand for organs means many either die or are removed from the waiting-list before receiving a kidney allograft. Reducing unnecessary discard of deceased donor kidneys is important to maximize utilization of a scarce and valuable resource but requires nuanced decision-making. Accepting kidneys from deceased donors with heterogenous characteristics for waitlisted kidney transplant candidates, often in the context of time-pressured decision-making, requires an understanding of the association between donor characteristics and kidney transplant outcomes. Deceased donor clinical factors can impact patient and/or kidney allograft survival but risk-versus-benefit deliberation must be balanced against the morbidity and mortality associated with remaining on the waiting-list. In this article, the association between deceased kidney donor characteristics and post kidney transplant outcomes for the recipient are reviewed. While translating this evidence to individual kidney transplant candidates is a challenge, emerging strategies to improve this process will be discussed. Fundamentally, tools and guidelines to inform decision-making when considering deceased donor kidney offers will be valuable to both professionals and patients.

show abstract

Donor risk scores: can they predict renal transplant outcomes?

Cited by 2 publications

References 5 publications

Prediction of Three-Year Outcome of Renal Transplantation from Optimal Donors versus Expanded Criteria Donors

Prediction of Three-Year Outcome of Renal Transplantation from Optimal Donors versus Expanded Criteria Donors

Deceased Donor Characteristics and Kidney Transplant Outcomes

Contact Info

Product

Resources

About