Living donor risk model for predicting kidney allograft and patient survival in an emerging economy

Abstract

Similar to findings in high income countries, our study suggests that donor characteristics such as age, nephron dose, creatinine clearance and HLA match are important factors that determine the long-term patient and graft survival in low income countries. However, other crucial but undefined factors may play a role in determining the overall risk of graft failure and mortality in living kidney donor transplant recipients.

Data Challenges in Addressing Chronic Kidney Disease in Low- and Lower-Middle-Income Countries

“…65 Of the two prospective observational studies, one used a large urology and transplantation database to develop a risk prediction model for long-term patient and allograft outcomes following living-kidney donor transplantation in Pakistan. 66 The second study used prospectively collected data from the International Pediatric Peritoneal Dialysis Network registry to describe the relationship between economic wealth and chronic peritoneal dialysis practices and outcomes in children. 63 Of the four cross-sectional studies, one derived data from an international registry rather than a dedicated local renal registry to report the difference in prevalence of home hemodialysis between countries.…”

“… 64 Retrospective observational study India 2018 Patients treated with HD The Rajiv Aarogyasri Community Health Insurance Scheme 13,118 Clinical outcome and cost of care Thin 65 Retrospective observational study Myanmar 2004 All kidney transplant recipients and donors in the Myanmar renal transplantation program Patient databases 22 Donor and recipient outcomes Zafar et al. 66 Prospective observational study Pakistan 2018 Living-donor kidney transplant recipients 1993–2009 Single-center database 2283 Risk model predicting long-term patient and allograft outcomes CKD, chronic kidney disease; KRT, kidney replacement therapy (including hemodialysis, peritoneal dialysis, and kidney transplantation); HD, hemodialysis; PD, peritoneal dialysis. …”

The role of kidney transplantation as a component of integrated care for chronic kidney disease

“…In fact, it has been implemented successfully in some of the poorest of countries, provided there is broad commitment from medical practitioners and health authorities. 20 The minimum requirement would be the presence of legislation governing organ donation and transplantation, a committed team of health practitioners who have established protocols for donor assessment and follow-up and recipient care and ongoing management. It should be undertaken in the public sector to promote transparency, limit organ trafficking, and provide opportunities for sections of the community to gain access to treatment.…”