Martínez-Mier G, Ávila-Pardo SF, Méndez-López MT, Budar-Fernández LF, Soto-Miranda E, Romero-de Lara PI, González-Velázquez F, Lajud-Barquín FA, Zilli-Hernández S

Language: Spanish
References: 20
Page: 464-471
PDF size: 321.89 Kb.

ABSTRACT

Background: Kasiske developed a tool for predicting the risk of 5-year graft loss. We analyzed our results using this model.
Methods: 109 deceased donor kidney transplants were included. 5-year probability of graft survival was calculated during transplantation, seven days after transplantation and 1-year after transplantation. Z-test and ROC curves were used for proportion differences and discrimination ability.
Results: Mean age of donor and recipient was 33.7 and 33.9 years, respectively. 59.6% died due to trauma. Mean of years on dialysis was 3.7. 22.9% of patients had delayed graft function (DGF). Calculated 5-year probability of graft survival during transplantation time was 74.1%; 7 days after transplantation, 74.9%; and one year after transplantation, 76.4%. 5-year death censored graft survival was 64.9%. There were no differences between death-censored graft survival and calculated probabilities (Z-test), with a C-statistic value of 0.54 ± 0.6 (95%CI 0.42-0.65, p = 0.5) and 0.51 ± 0.6 (0.39-0.63, 95% CI, p = 0. 7) for transplant time and seven days after. C-statistic value 1-year after transplantation was 0.68 ± 0.8 (95%CI 0.52-0.84, p = 0.02).
Conclusion: Only calculated 5-year graft survival one year after transplantation had modest prediction ability.

REFERENCES

1. Hariharan S, Johnson CP, Bresnahan BA, Taranto SE, McIntosh MJ, Stablein D. Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med. 2000 Mar 2;342(9):605-12.

2. Schnitzler MA, Whiting JF, Brennan DC, Lentine KL, Desai NM, Chapman W, et al. The life-years saved by a deceased organ donor. Am J Transplant. 2005 Sep;5(9):2289-96.

3. Goldfarb-Rumyantzev AS, Scandling JD, Pappas L, Smont RJ, Horn S. Prediction of 3-yr cadaveric graft survival based on pre-tansplant variables in a large national dataset. Clin Transplant. 2003;17:715-21.

4. Nyberg SL, Matas AJ, Rogers M, Harmsen WS, Velosa JA, Larson TS, et al. Donor scoring system for cadaveric renal transplantation. Am J Transplant. 2001 Jul;1(2):162-70.

5. Nyberg SL, Matas AJ, Kremers WK, Thostenson JD, Larson TS, Prieto M, et al. Improved Scoring System to Assess Adult Donors For Cadaver Renal Transplantation. Am J Transplant. 2003 Jun;3(6):715-21.

6. Ojo AO, Hanson JA, Meier-Kreische H, Okechukwu CN, Wolfe RA, Leichtman AB, et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J Am Soc Nephrol. 2001 Mar;12(3):589-97.

7. Ojo AO, Leichtman AB, Punch JD, Hanson JA, Dickinson DM, Wolfe RA, et al. Impact of pre-existing donor hypertension and diabetes mellitus on cadaveric renal transplant outcomes. Am J Kidney Dis. 2000 Jul;36(1):153-9.

8. Goldfarb-Rumyantzev AS, Hurdle JF, Scandling JD, Baird BC, Cheung AK. The role of pretransplant renal replacement therapy modality in kidney allograft and recipient survival. Am J Kidney Dis. 2005 Sep;46(3):537-49.

9. Goldfarb-Rumyantzev A, Hurdle JF, Scandling J, Wang Z, Baird B, Barenbaum L, et al. Duration of endstage renal disease and kidney transplant outcome. Nephrol Dial Transplant. 2005 Jan;20(1):167-75.

10. Baskin-Bay ES, Kremers W, Nyberg SL. A recipient risk score for deceased donor renal allocation. Am J Kidney Dis. 2007 Feb;49(2):284-93.

11. Schold JD, Kaplan B, Baliga RS, Meier-Kriesche HU. The broad spectrum of quality in deceased donor kidneys. Am J Transplant. 2005 Apr;5(4 Pt 1):757-65.

12. Rao SP, Schaubel DE, Guidinger MK, Andreoni KA, Wolfe RA, Merion RM, et al. A comprehensive Risk Quantifi cation Score for Deceased Donor Kidneys: The Kidney Donor Risk Index. Transplantation. 2009 Jul 27;88(2):231-6.

13. Krikov S, Khan A, Baird BC, Barenbaum LL, Leviatov A, Koford JK, et al. Predicting kidney trasnsplant survival using tree-based modeling. ASAIO J. 2007 Sep-Oct;53(5):592-600.

14. Machniki G, Pinsky B, Takemoto S, Balshaw R, Salvalaggio PR, Buchanan PM, et al. Predictive Ability of Pretransplant Comorbidities to Predict Long- Term Graft Loss and Death. Am J Transplant. 2009 Mar;9(3):494-505.

15. Moore J, He X, Shabir S, Hanvesakul R, Benavente D, Cockwell P, et al. Development and Evaluation of a Composite Risk Score to Predict Kidney Transplant Failure. Am J Kidney Dis 2001;57(5):744-51.

16. Shabir S, Halimi JM, Cherukuri A, Ball S, Ferro C, Lipkin G, et al. Predicting 5-year Risk of Kidney Transplant Failure: A Prediction Instrument Using Data Available at 1 Year Posttransplantation. Am J Kidney Dis. 2014 Apr;63(4):643-51.

17. Hernández D1, Sánchez-Fructuoso A, González- Posada JM, Arias M, Campistol JM, Rufi no M, et al. A novel risk score for mortality in renal transplant recipient beyond the fi rst posttransplant year. Transplantation. 2009 Sep 27;88(6):803-9.

18. Kasiske BL, Israni AK, Synder JJ, Skeans MA, Peng Y, Weinhandl ED. A simple Tool to Predict Outcomes After Kidney Transplant. Am J Kidney Dis. 2010 Nov;56(5):947-60.

19. McAdams-DeMarco MA, Law A, King E, Orandi B, Salter M, Gupta N, et al. Frailty and mortality in kidney transplant recipients. Am J Transplant. 2015 Jan;15(1):149-54

20. Molnar MZ, Kovesdy CP, Bunnapradist S, Streja E, Mehrotra R, Krishnan M, et al. Associations of pretransplant serum albumin with post-transplant outcomes in kidney transplant recipients. Am J Transplant. 2011 May;11(5):1006-15.