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deceased kidney transplantation:尸肾移植;delayed graft function:移植肾功能延迟恢复。 对尸肾移植移植肾功能延迟恢复预测模型的评估

Evaluation of predictive models for delayed graft function of deceased kidney transplantation.

作者信息

Zhang Huanxi, Zheng Linli, Qin Shuhang, Liu Longshan, Yuan Xiaopeng, Fu Qian, Li Jun, Deng Ronghai, Deng Suxiong, Yu Fangchao, He Xiaoshun, Wang Changxi

机构信息

Organ Transplant Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.

Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, China.

出版信息

Oncotarget. 2017 Nov 27;9(2):1735-1744. doi: 10.18632/oncotarget.22711. eCollection 2018 Jan 5.

Abstract

BACKGROUND

This study aimed to evaluate the predictive power of five available delayed graft function (DGF)-prediction models for kidney transplants in the Chinese population.

RESULTS

Among the five models, the Irish 2010 model scored the best in performance for the Chinese population. Irish 2010 model had an area under the receiver operating characteristic (ROC) curve of 0.737. Hosmer-Lemeshow goodness-of-fit test showed that the Irish 2010 model had a strong correlation between the calculated DGF risk and the observed DGF incidence ( = 0.887). When Irish 2010 model was used in the clinic, the optimal upper cut-off was set to 0.5 with the best positive likelihood ratio, while the lower cut-off was set to 0.1 with the best negative likelihood ratio. In the subgroup of donor aged ≤ 5, the observed DGF incidence was significantly higher than the calculated DGF risk by Irish 2010 model (27% vs. 9%).

MATERIALS AND METHODS

A total of 711 renal transplant cases using deceased donors from China Donation after Citizen's Death Program at our center between February 2007 and August 2016 were included in the analysis using the five predictive models (Irish 2010, Irish 2003, Chaphal 2014, Zaza 2015, Jeldres 2009).

CONCLUSIONS

Irish 2010 model has the best predictive power for DGF risk in Chinese population among the five models. However, it may not be suitable for allograft recipients whose donor aged ≤ 5-year-old.

摘要

背景

本研究旨在评估五种现有的延迟移植肾功能(DGF)预测模型对中国人群肾移植的预测能力。

结果

在这五种模型中,爱尔兰2010模型在中国人群中的表现最佳。爱尔兰2010模型的受试者工作特征(ROC)曲线下面积为0.737。Hosmer-Lemeshow拟合优度检验表明,爱尔兰2010模型计算出的DGF风险与观察到的DGF发生率之间具有很强的相关性(=0.887)。当在临床中使用爱尔兰2010模型时,最佳上限设定为0.5,阳性似然比最佳,而下限设定为0.1,阴性似然比最佳。在供体年龄≤5岁的亚组中,观察到的DGF发生率显著高于爱尔兰2010模型计算出的DGF风险(27%对9%)。

材料与方法

对2007年2月至2016年8月在本中心进行的711例使用公民死亡后捐赠项目中已故供体的肾移植病例,使用五种预测模型(爱尔兰2010、爱尔兰2003、查法尔2014、扎扎2015、杰尔德雷斯2009)进行分析。

结论

在这五种模型中,爱尔兰2010模型对中国人群DGF风险的预测能力最佳。然而,它可能不适用于供体年龄≤5岁的同种异体肾移植受者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4f8/5788595/a4a07dfa80ae/oncotarget-09-1735-g001.jpg

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