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欧洲移植高级项目中肾脏供体风险指数与肾移植术后结局的关联

Association of Kidney Donor Risk Index with the Outcome after Kidney Transplantation in the Eurotransplant Senior Program.

作者信息

Schamberger Beate, Lohmann Dario, Sollinger Daniel, Stein Raimund, Lutz Jens

机构信息

Medical Clinic, Section of Nephrology and Infectious Diseases, Gemeinschaftsklinikum Mittelrhein, Koblenz, Germany.

Medical Clinic III, Section of Nephrology, University Hospital Frankfurt, Frankfurt, Germany.

出版信息

Ann Transplant. 2018 Nov 6;23:775-781. doi: 10.12659/AOT.909622.

Abstract

BACKGROUND We evaluated the Kidney Donor Risk Index (KDRI) scoring system for kidney transplantation in the Eurotransplant Senior Program (ESP) that allocates kidneys from older donors to older recipients (≥65 years). MATERIAL AND METHODS We retrospectively analyzed data of 37 kidney transplant recipients and 36 kidney donors who participated in kidney transplantation program according to the ESP at our center from January 2004 until December 2013. RESULTS Mean recipient and donor age was 67.9±2.6 and 70.5±4.0 years respectively. The mean KDRI score was 1.7±0.27. Uncensored graft survival after 1 year and 5 years was 64.2% and 53.7% respectively. Subgroup analysis showed that in kidney transplantation with KDRI >1.83, graft survival was significantly reduced compared to lower KDRI subgroups. KDRI was significantly correlated with serum creatinine level at discharge (r=0.4). CONCLUSIONS ESP kidneys represent a group of high-risk grafts with high KDRI scores. Higher KDRI scores in ESP kidneys was associated with reduced postoperative short-term and long-term graft outcomes. KDRI might be useful in decision-making for selecting donors for ESP kidney transplantation.

摘要

背景

我们评估了欧洲移植高级计划(ESP)中用于肾移植的肾脏供体风险指数(KDRI)评分系统,该计划将老年供体的肾脏分配给老年受者(≥65岁)。材料与方法:我们回顾性分析了2004年1月至2013年12月在我们中心根据ESP参与肾移植项目的37例肾移植受者和36例肾脏供体的数据。结果:受者和供体的平均年龄分别为67.9±2.6岁和70.5±4.0岁。KDRI平均评分为1.7±0.27。1年和5年时未删失的移植物存活率分别为64.2%和53.7%。亚组分析显示,在KDRI>1.83的肾移植中,与较低KDRI亚组相比,移植物存活率显著降低。KDRI与出院时的血清肌酐水平显著相关(r=0.4)。结论:ESP肾脏代表一组KDRI评分高的高风险移植物。ESP肾脏中较高的KDRI评分与术后短期和长期移植物结局降低有关。KDRI可能有助于ESP肾移植供体选择的决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b52/6248015/834f14804ca7/anntransplant-23-775-g001.jpg

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