Kidney Week

Abstract: FR-PO1040

SCD ≠ KDPI <0.85

Session Information

• Transplantation: Donor-Candidate Assessment and Predictors of Outcome
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Chen, Shan Shan, University of New Mexico, Albuquerque, New Mexico, United States

Shan Shan Chen,

• Pankratz, V. Shane, University of New Mexico, Albuquerque, New Mexico, United States

V. Shane Pankratz,

• Al-Odat, Rawan T., University of New Mexico, Albuquerque, New Mexico, United States

Rawan T. Al-Odat,

• Unruh, Mark L., University of New Mexico, Albuquerque, New Mexico, United States

Mark L. Unruh,

• Ng, Yue-Harn, University of New Mexico, Albuquerque, New Mexico, United States

Yue-Harn Ng,

Background

The new kidney allocation system (KAS) assigns a kidney with Kidney Donor Profile Index (KDPI) > 0.85 [K>85] as high risk for allograft failure. Differences exist between the previous and current KAS: previous study showed that 8.3% of Expanded Criteria Donor (ECD) kidneys have a KDPI of < 0.85 (K<85). Outcomes following transplant of “discordant kidneys” (DK) is unclear. In this study, we compared the outcomes of DKs vs "concordant kidneys" (CK) using data from the Scientific Registry of Transplant Recipients.

Methods

We retrospectively calculated the KDPI of all kidneys transplanted from 2003 to 2016 and divided them into standard CK (Standard Criteria Donor [SCD] + K<85), expanded CK (ECD+K>85), standard DK (SCD+K>85) or expanded DK (ECD + K<85). We compared the characteristics of recipients who received different kidneys and assessed the rates of allograft failure for these kidneys.

Results

From 2003 to 2016, 148,887 kidney transplants were performed in the US with 16,222 (10.9%) DK transplanted. Significant differences were noted among the recipients of different donor kidney types [Table1]. Recipients of K>85 kidneys had poorer allograft survival compared to recipient of K<85 kidneys. Standard DK recipients had higher risk of allograft loss compared to expanded CK recipients. Recipients of expanded DK had higher risk of allograft failure compared to standard CK recipients [Fig1].

Conclusion

The new KAS is superior to the old KAS at predicting allograft failure. However, recipient of expanded DKs need to be counseled about the higher risk of graft loss compared to standard CKs.

Funding

• Commercial Support –