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10.1111/ajt.12928

http://scihub22266oqcxt.onion/10.1111/ajt.12928
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suck abstract from ncbi


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pmid25155294
      Am+J+Transplant 2014 ; 14 (11 ): 2515-25
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  • The Kidney Donor Profile Index (KDPI) of marginal donors allocated by standardized pretransplant donor biopsy assessment: distribution and association with graft outcomes #MMPMID25155294
  • Gandolfini I ; Buzio C ; Zanelli P ; Palmisano A ; Cremaschi E ; Vaglio A ; Piotti G ; Melfa L ; La Manna G ; Feliciangeli G ; Cappuccilli M ; Scolari MP ; Capelli I ; Panicali L ; Baraldi O ; Stefoni S ; Buscaroli A ; Ridolfi L ; D'Errico A ; Cappelli G ; Bonucchi D ; Rubbiani E ; Albertazzi A ; Mehrotra A ; Cravedi P ; Maggiore U
  • Am J Transplant 2014[Nov]; 14 (11 ): 2515-25 PMID25155294 show ga
  • Pretransplant donor biopsy (PTDB)-based marginal donor allocation systems to single or dual renal transplantation could increase the use of organs with Kidney Donor Profile Index (KDPI) in the highest range (e.g. >80 or >90), whose discard rate approximates 50% in the United States. To test this hypothesis, we retrospectively calculated the KDPI and analyzed the outcomes of 442 marginal kidney transplants (340 single transplants: 278 with a PTDB Remuzzi score<4 [median KDPI: 87; interquartile range (IQR): 78-94] and 62 with a score=4 [median KDPI: 87; IQR: 76-93]; 102 dual transplants [median KDPI: 93; IQR: 86-96]) and 248 single standard transplant controls (median KDPI: 36; IQR: 18-51). PTDB-based allocation of marginal grafts led to a limited discard rate of 15% for kidneys with KDPI of 80-90 and of 37% for kidneys with a KDPI of 91-100. Although 1-year estimated GFRs were significantly lower in recipients of marginal kidneys (-9.3, -17.9 and -18.8?mL/min, for dual transplants, single kidneys with PTDB score<4 and =4, respectively; p<0.001), graft survival (median follow-up 3.3 years) was similar between marginal and standard kidney transplants (hazard ratio: 1.20 [95% confidence interval: 0.80-1.79; p=0.38]). In conclusion, PTDB-based allocation allows the safe transplantation of kidneys with KDPI in the highest range that may otherwise be discarded.
  • |*Graft Survival [MESH]
  • |*Kidney/pathology [MESH]
  • |*Tissue Donors [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Biopsy [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Male [MESH]


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