Kidney Week

Abstract: SA-PO078

Clinical Significance of Kidney Donor Profile Index on the Post-Transplant Clinical Outcomes Between Elderly and Young Kidney Transplant Recipients: A Multicenter Cohort Study

Session Information

• Transplantation: Recipient and Donor Assessment
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Woo Yeong Park,

• Lee, Jong hoon, Seoul St. Mary's Hospital , Seoul, Korea (the Republic of)

Jong hoon Lee,

• Kim, Jeong Ho, Daejeon St. Mary's Hospital, Daejeon, Korea (the Republic of)

Jeong Ho Kim,

• Jin, Kyubok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Kyubok Jin,

• Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Seungyeup Han,

• Choi, Bumsoon, Seoul St. Mary's Hospital , Seoul, Korea (the Republic of)

Bumsoon Choi,

• Yang, Chul Woo, Seoul St. Mary's Hospital , Seoul, Korea (the Republic of)

Chul Woo Yang,

• Chung, Byung ha, Seoul St. Mary's Hospital , Seoul, Korea (the Republic of)

Byung ha Chung,

Background

We investigated the clinical significance of Kidney Donor Profile Index (KDPI) system for the prediction of the clinical outcomes of elderly- or young kidney transplant recipients (KTRs) in deceased donor kidney transplantation (DDKT).

Methods

Six hundred fifty-seven KTRs receiving kidneys from 526 deceased donors (DDs) were included from four transplant centers. We divided high KDPI and low KDPI by 65%, the median value of KDPI score, and divided elderly KTRs and young KTRs at 55 years old. We investigated the incidence of delayed graft function (DGF), biopsy-proven acute rejection (BPAR), allograft and patient survival rates between elderly and young KTRs donated from DDs with high KDPI- or low KDPI score.

Results

We analyzed 224 (34.1%) elderly KTRs and 433 (65.9%) young KTRs. There were no significant differences in the incidence of DGF and BPAR between elderly KTRs and young KTRs donated from DDs with high KDPI- or low KDPI score. In elderly KTRs, there was no significant difference of death-censored graft survival and patient survival rates between high KDPI-KT and low KDPI-KT groups. However, in young KTRs, high KDPI-KT group was significantly lower in death-censored graft survival rate compared with low KDPI-KT group (P=0.006), and there was no significant difference of patient survival rate between the two groups. In multivariate analysis, high KDPI score was an independent risk factor for allograft failure in young KTRs after adjustment for recipient and donor age, gender, acute rejection, and induction immunosuppresant (HR 2.376, 95% C.I., 1.251-4.511, P = 0.008), but not in the elderly KTRs. Among 4 groups, high KDPI-young KT group showed the highest risk for allograft failure compared with other three groups and a significant interaction between high KDPI donors and young KTRs on the allograft outcome (P=0.002).

Conclusion

High KDPI in DDs showed significant adverse impact on the allograft survival in young KTRs, but it was not prognostic factor in elderly KTRs.