2019, Number 3
<< Back Next >>
Rev Med Inst Mex Seguro Soc 2019; 57 (3)
Patient survival scale after kidney transplant from deceased donors in Veracruz, Mexico
Martínez-Mier G, Soto-Miranda E, Moreno-Ley PI, Méndez-López MT, Budar-Fernández LF, Ávila-Pardo SF, Aguilar-Sandoval EG, Zilli-Hernández S, Lajud-Barquín F, Vega-Rojano L, Coello-Torres G
Language: Spanish
References: 25
Page: 149-155
PDF size: 191.46 Kb.
ABSTRACT
Background: The Estimated Post Transplant Survival
(EPTS) score is calculated based on age, the presence
of diabetes mellitus, years on dialysis, and prior organ
transplant. It has been validated in other countries.
Objective: To apply and assess the EPTS score in our
population of deceased-donor kidney transplants.
Materials and methods: Retrospective study of adult
deceased-donor kidney transplants from January, 2003,
to December, 2016. For the statistical analysis it was
used Spearman’s correlation, receiver-operator curves
(ROC) and Kaplan-Meier curves. A p value ‹ 0.05 was
considered statistically significant.
Results: 176 adult deceased-donor kidney transplants
were included. Medium age was 34.7 ± 11 years; 53.4%
were men, 4% diabetics; mean dialysis time was 5.5 ± 3.9
years and 4% had a prior organ transplant. The medium
of EPTS score was 16.3 ± 18.7 (1-94). Spearman’s
correlation was −0.394 (
p = 0.0001). C value (ROC) was
0.64 ± 0.6 (95% CI, 0.52-0.75) (
p = 0.011). Medium
survival calculated with Kaplan-Meier in patients with an
EPTS score ‹ 20, was 10.2 ± 0.3 years (95% CI, 9.5-10.9)
versus patients with EPTS score › 20: 7.03 ± 0.9 years
(95% CI, 5.1-8.9) (
p = 0.001). Each 20% increase of
EPTS, patient survival time diminished (
p = 0.0001).
Conclusions: The EPTS score is a useful tool for
establishing survival in adult Mexican recipients of
deceased-donor kidney transplants.
REFERENCES
Organ Procurement and Transplantation Network [Internet]. A Guide to Calculating and Interpreting the Estimated Post-Transplant Survival (EPTS) Score Used in the Kidney Allocation System (KAS). Richmond, Virginia: OPTN; actualizado el 17 de mayo de 2019. Disponible en https://optn.transplant.hrsa.gov/media/ 1511/guide_to_calculating_interpreting_epts.pdf
Freitas MC. Kidney transplantation in the US: an analysis of the OPTN/UNOS registry. Clin Transpl. 2011:1-16.
Andre M, Huang E, Everly M, Bunnapradist S. The UNOS Renal Transplant Registry: Review of the Last Decade. Clin Transpl. 2014:1-12.
Clayton PA, McDonald SP, Snyder JJ, Salkowski N, Chadban SJ. External validation of the estimated posttransplant survival score for allocation of deceased donor kidneys in the United States. Am J Transplant. 2014;14(8):1922-6. doi: 10.1111/ajt.12761.
Organ Procurement and Transplantation Network [Internet]. EPTS calculator. Richmond, Virginia: OPTS; guías de cálculo actualizadas el 17 de mayo de 2019. Disponible en https://optn.transplant.hrsa.gov/resources/ allocation-calculators/epts-calculator/
Ramanathan R, Gupta G, Kim J, Quinn K, Behnke M, Kang L et al. Retroactive Application of the New Kidney Allocation System to Renal Transplants Performed in the ECD/SCD era. Clin Transplant 2015;29:1148-55.
Wang CJ, Wetmore JB, Israni AK. Old versus new: Progress in reaching the goals of the new kidney allocation system. Hum Immunol. 2017;78(1):9-15. doi: 10.1016/j.humimm.2016.08.007
Stewart DE, Klassen DK. Early Experience with the New Kidney Allocation System: A Perspective from UNOS. Clin J Am Soc Nephrol. 2017;12:2063-5.
Chopra B, Sureshkumar KK. Changing Organ Allocation Policy for Kidney Transplantation in the United States. World J Transplant. 2015;5(2):38-43.
Schold JD, Buccini LD, Reese PP, Poggio ED, Goldfarb DA. Effect of Dialysis Initiation for Preemptively Listed Candidates in the Revised Kidney Allocation Policy. Am J Transplant. 2014;14(12):2855-60.
Andreoni KA, Thomas EM, Battula B, Zarrinpar A, Johnson MW. Is the Updated Kidney Allocation System Working? Curr Transpl Rep. 2018;5(2):166-73.
Moss M, Gillespie M, Sparkes T, Ravichandran B, Ugarte R, Haririan A. Kidney Allocation Tool of the Future: The Estimated Post-Transplant Survival (EPTS) Score. 2015 American Transplant Congress. Abstract number: A140. Disponible en https://atcmeetingabstracts.com/abstract/ kidney-allocation-tool-of-the-future-the-estimated-posttransplant- survival-epts-score/
Stewart D, Kucheryavaya A, Boyle G, Aeder M, Formica R. Should Only Active Candidates Define the EPTS Top 20% in the New Kidney Allocation System (KAS). 2015 American Transplant Congress. Abstract number: 89. Disponible en https://atcmeetingabstracts.com/abstract/ should-only-active-candidates-define-the-epts-top-20-inthe- new-kidney-allocation-system-kas/
Schold J, Poggio E, Fatica R, Flechner S, Buccini L, Goldfarb D. The Simplified EPTS Score: Who Wins and Who Loses? 2016 American Transplant Congress. Abstract number: C85. Disponible en https://atcmeetingabstracts.com/abstract/thesimplified- epts-score-who-wins-and-who-loses/
Liu A, Balabhadrapatruni K, Augustine J. Watch Out for the Guy the Low EPTS Score: Nonadherence and Kidney Allograft Failure. 2016 American Transplant Congress. Abstract number: A283. Disponible en https://atcmeetingabstracts.com/ abstract/watch-out-for-the-guy-with-the-low-epts-scorenonadherence- and-kidney-allograft-failure/
Staeck O, Khadzhynov D, Kleinsteuber A, Lehner L, Duerr M, Budde K, et al. Evaluation of Scoring Systems Predicting Patient Survival at Time of Kidney Transplantation. 2016 American Transplant Congress. Abstract number: 43. Disponible en https://atcmeetingabstracts.com/abstract/ evaluation-of-scoring-systems-predicting-patient-survival-attime- of-kidney-transplantation/
Cantú-Quintanilla G, Sales-Heredia F, Reyes-López A, Rodríguez-Ortega G, Medeiros-Domingo M. En Hospitales en México: criterios de asignación de riñón de pacientes fallecidos. Persona y Bioética, 2009;13(1):20-33. Disponible en http://www.scielo.org.co/scielo.php?script=sci_arttext& pid=S0123-31222009000100003
Calisa V, Craig JC, Howard K, Howell M, Alexander S, Chadban SJ et al. Survival and quality of life impact of a risk-based allocation algorithm for deceased donor kidney transplantation. Transplantation. 2018;102(9): 1530-7. doi: 10.1097/TP.0000000000002144.
Li B, Cairns J, Robb ML, RJ Johnson, Watson CJ, Forsythe JL, et al. Predicting patient survival after deceased donor kidney transplantation using flexible parametric modelling. BMC Nephrol. 2016 May 25;17(1): 51. doi: 10.1186/s12882-016-0264-0.
Veroux M, Corona D, Veroux P. Kidney transplantation: future challenges. Minerva Chir. 2009;64(1):75-100.
Kang SS, Park HY, Yeo SM, Park WY, Han S, Park SB, et al. Comparison of Clinical Outcomes of Deceased Donor Kidney Transplantation according to Donor Evaluation Criteria. Transplantation. 2017;101:S127.
García del Moral Martín RM, Retamero-Díaz JA, Cava- Molina M, Cobacho-Tornel BM, Bravo-Soto J, Osuna- Ortega A et al. Validación del KDRI/KPDI para la selección de donantes renales con criterios expandidos. Nefrologia 2018;38(3):297-303. doi: 10.1016/j.nefro.2017.08.006
Knoll G. Trends in kidney transplantation over the past decade. Drugs. 2008;68 Suppl 1:3-10.
Pascual J, Pérez-Sáez MJ. Kidney Donor Profile Index: Can it be extrapolated to our environment? Nefrologia. 2016;36:465-8.
Israni AK, Salkowski N, Gustafson S, Snyder JJ, Friedewald JJ, Formica RN, et al. New national allocation policy for deceased donor kidneys in the United States and possible effect on patient outcomes. J Am Soc Nephrol. 2014;25(8):1842-8. doi: 10.1681/Asn.2013070784