Abstract: FR-PO1207
Outcomes of Deceased Donor Kidney Transplant Recipients Based on Age and Kidney Donor Profile Index
Session Information
- Transplantation: Clinical - Immunosuppression, Adherence, Outcomes
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Bodnar, Josh, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
- Srivastava, Aniruddha, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
- Parajuli, Sandesh, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
- Astor, Brad C., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
- Muth, Brenda L., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
Background
The Kidney Donor Profile Index (KDPI) is a score used to estimate the overall quality of a deceased-donor kidney prior to transplant. This study sought to determine the outcomes of receiving KDPI >85% Kidneys relative to KDPI <85% kidneys based on graft survival and patient survival at two different age groups.
Methods
This was an observational study of all deceased-donor kidney transplant recipients >40 years of age at the time of transplant between 2011 and 2015 at our University hospital (n=837). Patients were divided into two groups, group 1 included patients between >40 and 59 years of age at the time of transplant (n=176) who received a KDPI >85% (n=15) or KDPI ≤85% (n=161). Group 2 included patients >60 years of age (n=121) who received a KDPI >85% (n=11) or KDPI ≤85% (n=110).
Results
Most of the baseline characteristics were similar across groups. Around 25-27% of ESRD was due to Diabetes (DM) in both groups, Recipients were on dialysis for a longer time in group 1 compared to group 2. In the univariate analysis, KDPI >85% or presence of delayed graft function (DGF) in either group were not associated with patient or graft survival. However, DM as a cause of ESRD was significantly associated with increased risk of graft failure and patient death in group 2 but not in group 1. Similarly, the use of depleting induction immunosuppressive compared to the non-depleting agent was significantly associated with increased risk of graft failure and patient death in both groups. After adjustment in multivariate analysis, in group 1, DM was associated with increased risk of graft failure [HR: 1.4, CI: 1.0-1.9, p=0.03] and death [HR: 1.44, CI: 1.1-1.9, p=0.03], along with in group 2 for graft failure [HR: 1.76, CI: 1.2-2.6, p=0.003] and death [HR: 1.75, CI: 1.2-2.5, p=0.002]. The similar, association was found for the use of depleting immunosuppressive medications in both groups for graft and patient survival.
Conclusion
In our observation, elevated KDPI >85% and delayed graft function were not associated with patient or graft survival regardless of age. The provider should consider these factors during transplant.