Division of Nephrology and Transplant Immunology, University of Alberta, Edmonton, AB, Canada.
Clin Transplant. 2013 Jul-Aug;27(4):517-22. doi: 10.1111/ctr.12135. Epub 2013 Jun 3.
Donor organ quality is a key determinant of graft function, and considerable efforts have been made to identify donor and transplant factors predicting inferior outcomes. This has resulted in the development of various scoring tools to aid in allocation of kidneys.
The performance of four donor quality scoring systems in predicting delayed graft function, and death-censored graft failure was examined in a single-center cohort of 730 consecutive deceased donor kidneys transplanted between 1990 and 2004. The predictive accuracy of the variables was analyzed with receiver operating characteristic curves and graft survival distribution.
The three outcome tools, that is, deceased donor score (DDS; Am J Transplant, 3, 2003, 715), donor risk score (DRS; Am J Transplant, 5, 2005, 757) and kidney donor risk index (KDRI; Transplantation, 88, 2009, 231) provided a significant and equivalent prediction of graft failure by using variables available at time of transplantation (p < 0.01). The risk of delayed graft function was predicted by the (DGF) nomogram (J Am Soc Nephrol, 14, 2003, 2967; Am J Transplant 10, 2010, 2279) with a high degree of discrimination (concordance index of 0.69, p < 0.01).
Our findings validate four pre-operative clinical scoring tools to predict early and late graft outcome in an independent, single-center set of kidney transplants.
供体器官质量是移植物功能的关键决定因素，人们已经做出了相当大的努力来确定预测不良结果的供体和移植因素。这导致了各种评分工具的发展，以帮助分配肾脏。
在 1990 年至 2004 年间连续接受 730 例已故供体肾脏移植的单中心队列中，检查了四种供体质量评分系统预测延迟移植物功能和死亡相关移植物失败的性能。使用接收者操作特征曲线和移植物生存分布分析变量的预测准确性。
三种结果工具，即已故供体评分（DDS；Am J Transplant，3，2003，715）、供体风险评分（DRS；Am J Transplant，5，2005，757）和肾脏供体风险指数（KDRI；移植，88，2009，231）使用移植时可用的变量提供了对移植物失败的显著和等效预测（p < 0.01）。延迟移植物功能的风险由（DGF）列线图（J Am Soc Nephrol，14，2003，2967；Am J Transplant 10，2010，2279）预测，具有高度的辨别力（一致性指数为 0.69，p < 0.01）。
我们的发现验证了四种术前临床评分工具，可在独立的单中心肾脏移植组中预测早期和晚期移植物结局。
