A Risk Index for Living Donor Kidney Transplantation

A. B. Massie; J. Leanza; L. M. Fahmy; E. K.H. Chow; N. M. Desai; X. Luo; E. A. King; M. G. Bowring; D. L. Segev

doi:10.1111/ajt.13709

A Risk Index for Living Donor Kidney Transplantation

A. B. Massie, J. Leanza, L. M. Fahmy, E. K.H. Chow, N. M. Desai, X. Luo, E. A. King, M. G. Bowring, D. L. Segev

School of Medicine

Research output: Contribution to journal › Article › peer-review

62 Scopus citations

Abstract

Choosing between multiple living kidney donors, or evaluating offers in kidney paired donation, can be challenging because no metric currently exists for living donor quality. Furthermore, some deceased donor (DD) kidneys can result in better outcomes than some living donor kidneys, yet there is no way to compare them on the same scale. To better inform clinical decision-making, we created a living kidney donor profile index (LKDPI) on the same scale as the DD KDPI, using Cox regression and adjusting for recipient characteristics. Donor age over 50 (hazard ratio [HR] per 10 years = _1.151.24_1.33), elevated BMI (HR per 10 units = _1.011.09_1.16), African-American race (HR = _1.151.25_1.37), cigarette use (HR = _1.091.16_1.23), as well as ABO incompatibility (HR = _1.031.27_1.58), HLA B (HR = _1.031.08_1.14) mismatches, and DR (HR = _1.041.09_1.15) mismatches were associated with greater risk of graft loss after living donor transplantation (all p < 0.05). Median (interquartile range) LKDPI score was 13 (1–27); 24.2% of donors had LKDPI < 0 (less risk than any DD kidney), and 4.4% of donors had LKDPI > 50 (more risk than the median DD kidney). The LKDPI is a useful tool for comparing living donor kidneys to each other and to deceased donor kidneys.

Original language	English (US)
Pages (from-to)	2077-2084
Number of pages	8
Journal	American Journal of Transplantation
Volume	16
Issue number	7
DOIs	https://doi.org/10.1111/ajt.13709
State	Published - Jul 1 2016

Keywords

clinical research/practice
graft survival
kidney transplantation/nephrology
kidney transplantation: living donor

ASJC Scopus subject areas

Immunology and Allergy
Transplantation
Pharmacology (medical)

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10.1111/ajt.13709

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title = "A Risk Index for Living Donor Kidney Transplantation",

abstract = "Choosing between multiple living kidney donors, or evaluating offers in kidney paired donation, can be challenging because no metric currently exists for living donor quality. Furthermore, some deceased donor (DD) kidneys can result in better outcomes than some living donor kidneys, yet there is no way to compare them on the same scale. To better inform clinical decision-making, we created a living kidney donor profile index (LKDPI) on the same scale as the DD KDPI, using Cox regression and adjusting for recipient characteristics. Donor age over 50 (hazard ratio [HR] per 10 years = 1.151.241.33), elevated BMI (HR per 10 units = 1.011.091.16), African-American race (HR = 1.151.251.37), cigarette use (HR = 1.091.161.23), as well as ABO incompatibility (HR = 1.031.271.58), HLA B (HR = 1.031.081.14) mismatches, and DR (HR = 1.041.091.15) mismatches were associated with greater risk of graft loss after living donor transplantation (all p < 0.05). Median (interquartile range) LKDPI score was 13 (1–27); 24.2% of donors had LKDPI < 0 (less risk than any DD kidney), and 4.4% of donors had LKDPI > 50 (more risk than the median DD kidney). The LKDPI is a useful tool for comparing living donor kidneys to each other and to deceased donor kidneys.",

keywords = "clinical research/practice, graft survival, kidney transplantation/nephrology, kidney transplantation: living donor",

author = "Massie, {A. B.} and J. Leanza and Fahmy, {L. M.} and Chow, {E. K.H.} and Desai, {N. M.} and X. Luo and King, {E. A.} and Bowring, {M. G.} and Segev, {D. L.}",

note = "Funding Information: This work was supported by grant numbers K24DK101828 and R01DK096008 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Publisher Copyright: {\textcopyright} Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons",

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doi = "10.1111/ajt.13709",

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AU - Massie, A. B.

AU - Leanza, J.

AU - Fahmy, L. M.

AU - Chow, E. K.H.

AU - Desai, N. M.

AU - Luo, X.

AU - King, E. A.

AU - Bowring, M. G.

AU - Segev, D. L.

N1 - Funding Information: This work was supported by grant numbers K24DK101828 and R01DK096008 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Publisher Copyright: © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Choosing between multiple living kidney donors, or evaluating offers in kidney paired donation, can be challenging because no metric currently exists for living donor quality. Furthermore, some deceased donor (DD) kidneys can result in better outcomes than some living donor kidneys, yet there is no way to compare them on the same scale. To better inform clinical decision-making, we created a living kidney donor profile index (LKDPI) on the same scale as the DD KDPI, using Cox regression and adjusting for recipient characteristics. Donor age over 50 (hazard ratio [HR] per 10 years = 1.151.241.33), elevated BMI (HR per 10 units = 1.011.091.16), African-American race (HR = 1.151.251.37), cigarette use (HR = 1.091.161.23), as well as ABO incompatibility (HR = 1.031.271.58), HLA B (HR = 1.031.081.14) mismatches, and DR (HR = 1.041.091.15) mismatches were associated with greater risk of graft loss after living donor transplantation (all p < 0.05). Median (interquartile range) LKDPI score was 13 (1–27); 24.2% of donors had LKDPI < 0 (less risk than any DD kidney), and 4.4% of donors had LKDPI > 50 (more risk than the median DD kidney). The LKDPI is a useful tool for comparing living donor kidneys to each other and to deceased donor kidneys.

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KW - clinical research/practice

KW - graft survival

KW - kidney transplantation/nephrology

KW - kidney transplantation: living donor

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A Risk Index for Living Donor Kidney Transplantation

Abstract

Keywords

ASJC Scopus subject areas

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