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Abstract: TH-PO1012

Proposal of Score to Predict Outcome of Deceased Donor Renal Transplantation

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Felipe, Carlos rafael Almeida, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Alvarenga, Andre Sousa, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Miranda, Silvana Maria Carvalho, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Pereira jr, Gerson Marques, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Souza, Pedro Augusto Macedo, None, Belo Horizonte, Minas GErais, Brazil
  • Piana, Izabela Lara, Faculdade de Minas Faminas BH, Belo Horizonte, Brazil
  • Jorge, Ana elisa Souza, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
Background

Kidney Donor Profile Index (KPDI) correlated with graft loss and death. However, patients who received kidneys with the same KDPI may have different outcomes.

Methods

We developed a score system based on data of 113 deceased donor renal transplants (DDRT) from 01/2013 to 02/2016: mean age 50.7 years; mean cold ischemia time was 13.4 hours; 62% presented delayed graft function; the median of the KDPI was 53.5%. The score was calculated assigning one point for KDPI > 70%, donor serum creatinine > 2.0mg/dL and donor age > 50 years (table 1). Patients were divided in 4 groups according to the sum of points (0, 1 , 2, 3 points) and graft survival was evaluated for each group.

Results

Distribution of patients by points categories: 0 points - 47.8%; 1 point - 27.4%; 2 points - 19.5%; 3 points - 5.3%. One year graft survival was 88.4% for 0 points, 73.6% for 1 point (p = 0.0735 vs 0 pts), 61.5% for 2 points (P = 0.0076 vs 0 pts) and 0% for 3 points (p <0.0001 vs 0 pts). Combining kidneys with a score of 0 and 1 point, 1-year graft survival was 82.9%, significantly higher than kidneys with 2 points (p = 0.0368) and 3 points (p <0.0001) [figure 1].

Conclusion

Kidneys with 0 or 1 point had better survival, being acceptable for most transplant candidates. Kidneys with 2 points presented intermediate survival, and may be more suitable for candidates with a low expectation of obtaining a better graft in a timely manner. None of the 6 recipients who received 3-point kidneys had a functioning graft after 1 year, raising serious concerns about the acceptability of these organs.

Scoring points system
CriteriaPoints
KDPI > 70%1
Final Donor creatinine > 2,0mg/dL1
Donor age > 50 years1
Total  

Figure 1. Graft survival according to scoring points groups