Kidney Week

Abstract: TH-PO1013

Development of a New Prediction Model for Graft Function in Living Donor Kidney Transplantation

Session Information

• Transplant Recipient Education, Adherence, and Novel Risk Factors for Graft Loss
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Matsukuma, Yuta, Department of Medicine and Clinical Science, Fukuoka, Japan

Yuta Matsukuma,

• Masutani, Kosuke, Department of Medicine and Clinical Science, Fukuoka, Japan

Kosuke Masutani,

• Tanaka, Shigeru, Fukuoka Dental College, Fukuoka, Japan

Shigeru Tanaka,

• Tsuchimoto, Akihiro, Department of Medicine and Clinical Science, Fukuoka, Japan

Akihiro Tsuchimoto,

• Unagami, Kohei, Tokyo Women's Medical University, Tokyo, Japan

Kohei Unagami,

• Okumi, Masayoshi, Tokyo Women's Medical University, Tokyo, Japan

Masayoshi Okumi,

• Tanabe, Kazunari, Tokyo Women's Medical University, Tokyo, Japan

Kazunari Tanabe,

• Tsuruya, Kazuhiko, Department of Medicine and Clinical Science, Fukuoka, Japan

Kazuhiko Tsuruya,

• Kitazono, Takanari, Department of Medicine and Clinical Science, Fukuoka, Japan

Takanari Kitazono,

Background

In recent years, there has been an increase in usage of grafts from marginal donors in living donor kidney transplantation. Such donors have several co-existing atherosclerotic factors such as aging, hypertension, dyslipidemia, and relatively low renal function. A simple prediction model for post-operative graft function may help to determine whether marginal donors are suitable in clinical settings of living donor kidney transplantation.

Methods

We conducted a single-center retrospective cohort study using clinical and laboratory measurements to construct a prediction model for graft function at 1 year. Low graft function was defined as estimated glomerular filtration rate (eGFR) ≤ 45 mL/min/1.73m² at 1 year. A risk prediction model for low graft function was developed using multivariable logistic regression model with a stepwise backward elimination method.

Results

A total of 343 living donor kidney transplantation procedures were performed between January 2006 and May 2016. 123 patients had eGFR ≤ 45 mL/min/1.73m² at 1 year after transplantation. Risk prediction model for low graft function was developed using donor age, pre-operative eGFR, hypertension, and donor/recipient body weight mismatch. The incidence of low graft function increased linearly with increase in total risk scores (p for trend <0.01). This model demonstrated modest discrimination (c-statistics = 0.75) and good calibration (Hosmer–Lemeshow test: p=0.77).

Conclusion

A new prediction model computed from four pre-operative variables created in this study is simple and useful system in clinical settings for prediction of graft function at 1 year in living donor kidney transplantation.