在老年死者供肾的肾移植中，肾脏供体风险指数评分比肾脏供体特征指数更可靠。
Kidney Donor Risk Index Score Is More Reliable Than Kidney Donor Profile Index in Kidney Transplantation From Elderly Deceased Donors.
作者信息
Jun Heungman, Yoon Hye Eun, Lee Kang Wook, Lee Dong Ryeol, Yang Jaeseok, Ahn Curie, Han Sang Youb
机构信息
Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea.
Department of Internal Medicine, Incheon St. Mary's Hospital, the Catholic University of Korea, College of Medicine, Incheon, Korea.
出版信息
Transplant Proc. 2020 Jul-Aug;52(6):1744-1748. doi: 10.1016/j.transproceed.2020.03.005. Epub 2020 May 21.
BACKGROUND
It is unclear whether both Kidney Donor Profile Index (KDPI) and Kidney Donor Risk Index (KDRI) scores can be applied to elderly deceased donors (DDs). This study aimed to compare the predictive values of KDRI and KDPI for the occurrence of delayed graft function (DGF) in kidney transplantation (KT) from elderly DDs.
METHODS
The data for 1049 DD KTs from the database of the Korean Organ Transplant Registry were reviewed retrospectively.
RESULTS
The mean age of the 1049 DDs was 50.94 ± 10.57 years. A total of 224 DDs were ≥60 years old (21.35%). The mean KDRI and KDPI were 1.24 ± 0.40 and 63.58 ± 25.16, respectively. Ninety (8.6%) recipients had DGF postoperatively. The right-skewed distributions of KDRI in both elderly and nonelderly DDs were similar. However, the KDPI curve showed a sharp increase from a KDPI score of 60 in DDs aged ≥60 years. The areas under the curve (AUCs) of receiver operator characteristics (ROC) for KDPI and KDRI were different. In DDs aged <60 years, the estimated AUCs of ROC showed significant values for KDPI (0.577, 95% confidence interval, 0.503-0.637; P = .048) and KDRI (0.576, 0.505-0.639; P = .043). However, in DDs aged ≥60 years, KDRI score, not KDPI, was a significant value: KDRI, 0.633 (0.498-0.767; P = .034); KDPI, 0.530 (0.476-0.643; P = .138).
CONCLUSION
KDRI was more reliable in predicting graft outcome than KDPI in KT from elderly DDs. A longer follow-up period is needed to assess predictors for postoperative renal functions.
背景
肾脏供体特征指数（KDPI）和肾脏供体风险指数（KDRI）评分是否均可应用于老年 deceased 供体（DDs）尚不清楚。本研究旨在比较 KDRI 和 KDPI 对老年 DDs 肾脏移植（KT）中延迟移植肾功能（DGF）发生的预测价值。
方法
回顾性分析韩国器官移植登记数据库中 1049 例 DD KT 的数据。
结果
1049 例 DDs 的平均年龄为 50.94±10.57 岁。共有 224 例 DDs 年龄≥60 岁（21.35%）。KDRI 和 KDPI 的平均值分别为 1.24±0.40 和 63.58±25.16。90 例（8.6%）受者术后发生 DGF。老年和非老年 DDs 中 KDRI 的右偏分布相似。然而，KDPI 曲线在年龄≥60 岁的 DDs 中从 KDPI 评分 60 开始急剧上升。KDPI 和 KDRI 的受试者操作特征（ROC）曲线下面积（AUCs）不同。在年龄<60 岁的 DDs 中，ROC 的估计 AUCs 显示 KDPI（0.577，95%置信区间，0.503 - 0.637；P = 0.048）和 KDRI（0.576，0.505 - 0.639；P = 0.043）具有显著值。然而，在年龄≥60 岁的 DDs 中，KDRI 评分而非 KDPI 具有显著值：KDRI，0.633（0.498 - 0.767；P = 0.034）；KDPI，0.530（0.476 - 0.643；P = 0.138）。
结论
在老年 DDs 的 KT 中，KDRI 在预测移植结果方面比 KDPI 更可靠。需要更长的随访期来评估术后肾功能的预测指标。
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