ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO1127

Analysis of Donor Factors for Clinical Prediction of Recipient After Deceased Donor Renal Transplant in a Non-US Transplant System

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Oh, Joon Seok, Brigham and Women's Hospital, Boston, United States
  • Kim, Joong Kyung, Bong-Seng Memorial Hospital, Busan, Korea (the Republic of)
  • Milford, Edgar L., Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Chandraker, Anil K., Brigham and Women's Hospital, Boston, Massachusetts, United States
Background

There is little data on allograft survival based on deceased donor characteristics outside the United States. Conservative use of deceased donors based on concern for longer term allograft outcomes likely increases the discard rate of deceased donor kidneys despite international deficit of kidney donors. Using South Korea as a model, we analyzed deceased donor characteristics using 1-year creatinine in the recipient as a surrogate marker for longer term outcomes.

Methods

We analyzed 2,858 cases contained within the Korean Organ Transplant Registry data which had conducted renal transplant from 2009 to 2017. Univariate, multivariate linear regression analysis and 5-fold cross validation was performed to make a formula for estimating the serum creatinine of the recipient for 1 year after deceased donor kidney transplant.

Results

Univariate analysis indicated a number of different factors were significant in determining outcome, however only donor age, donor serum creatinine and current smoking status without hypertension were statistically significant in a multivariate model for predicting serum creatinine of the recipient after 1 year of transplant (Table 1). We also found that serum creatinine at 1 year predicted 3 year outcomes in a log rank test.

Conclusion

Currently deceased donor kidney transplant outcomes are extremely good in South Korea (despite a much longer period on dialysis prior to transplant) compared to the US. Given differences in cultural, economic and racial characteristics compared to the US the Korean prediction model obtained from this study relies on checking only 3 donor factors, and thus can be obtained relatively quickly and conveniently and yet provides more information to the recipient candidates before transplant. In particular, we also believe this study indicates that there is underutilization of potential decreased donors in Korea and that a wider pool of deceased donors could be used safely.

A model of expected 1-year post-transplant serum creatinine (mg/dL) of recipient who received deceased donor Renal Transplant in Korea. (Exp: Exponential)
Exp [0.009 × Donor Age
+ 0.015 × Donor Creatinine
- 0.060 × If Donor Hx. of Smoking
− 0.276]

(Donor’s Hx. of Smoking, 0: No Smoking or Former Smoking or Current Smoking with HTN, 1: Current Smoking without HTN), 5 fold cross validated R2=0.184, F-statistic: 64.79, p value <0.01