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The impact of kidney donor profile index on delayed graft function and transplant outcomes: A single‐center analysis
Author(s) -
Zens Tiffany J.,
Danobeitia Juan S.,
Leverson Glen,
Chlebeck Peter J.,
Zitur Laura J.,
Redfield Robert R.,
D'Alessandro Anthony M.,
Odorico Scott,
Kaufman Dixon B.,
Fernandez Luis A.
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13190
Subject(s) - medicine , single center , kidney , surgery , retrospective cohort study , urology
Renal transplant outcomes result from a combination of factors. Traditionally, donor factors were summarized by classifying kidneys as extended criteria or standard criteria. In 2014, the nomenclature changed to describe donor factors with the kidney donor profile index ( KDPI ). We aim to evaluate the relationship between KDPI and delayed graft function (DGF), and the impact KDPI on transplant outcomes for both donor after cardiac death ( DCD ) and donor after brain death ( DBD ). Methods An IRB ‐approved single‐center retrospective chart review was performed from January 1999 to July 2013. The patients were divided into six groups: DBD KDPI ≤60, DBD KPDI 61‐84, DBD KDPI ≥85, DCD KDPI ≤60, DCD KPDI 61‐84, and DCD KDPI ≥85. Rates of DGF , patient survival, and graft survival were examined among groups. Results A total of 2161 kidney transplants were included. DGF rates increased, and graft and patient survival decreased with increasing KDPI ( P < .001). DCD kidneys had higher DGF rates than their DBD counterparts ( P < .001). In DCD kidneys, a higher KDPI score did not significantly affect the DGF rates ( P > .302). There was no significant difference in graft or patient survival in all‐comers when comparing DCD and DBD kidneys with equivalent KDPI s ( P > .317). Patients with DGF across all categories demonstrated worse graft half‐lives. Conclusion The KDPI system is an accurate predictor of donor contributions to transplant outcomes. Recipients of DBD kidneys experience an increase in the rate of DGF as their KDPI increases. DCD kidneys have higher DGF rates than their DBD counterparts with similar KDPI s. Patients with documented post‐transplant DGF had between 3‐ and 5‐year shorter graft half‐lives when compared to recipients that did not experience DGF . Initiatives to reduce the rate of DGF could provide a significant impact on graft survival and result in a reduction in the number of patients requiring retransplant.