Retroactive Application of a New Risk Index for Living Donor Kidney Transplantation to Renal Transplants in Veracruz, Mexico.

Autor: Martinez-Mier G; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico; Veracruz State College of Surgeons, Veracruz, Mexico. Electronic address: gmtzmier@hotmail.com., Vazquez-Crespo LV; School of Medicine, Universidad Veracruzana Región Veracruz, Iturbide SN Centro Veracruz, México., Angeles-Hernández F; School of Medicine, Universidad Veracruzana Región Veracruz, Iturbide SN Centro Veracruz, México., Viñas-Dozal JC; Veracruz State College of Surgeons, Veracruz, Mexico; School of Medicine, Universidad Veracruzana Región Veracruz, Iturbide SN Centro Veracruz, México; UV-CA-477 Clinical Research Academic Committee, School of Medicine, Universidad Veracruzana, Región Veracruz, Iturbide SN Centro Veracruz, México., Moreno-Ley PI; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico., Budar-Fernández LF; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico., Méndez-López MT; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico., Allende-Castellanos CA; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico., Jiménez-López LA; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico., Bonilla-Casas E; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico., De la Paz-Román M; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico., Fuentes-Zamudio EE; Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades 14 Adolfo Ruiz Cortines, Cuauhtemoc SN Formando Hogar, Veracruz, Mexico.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2020 May; Vol. 52 (4), pp. 1077-1080. Date of Electronic Publication: 2020 Mar 18.
DOI: 10.1016/j.transproceed.2020.01.059
Abstrakt: Background: The Living Kidney Donor Profile Index (LKDPI) was recently created. This model predicts recipient risk of graft loss after living donor transplant. Herein, we applied the LDKPI to our population to analyze its performance.
Methods: A retrospective analysis of all living donor kidney transplants from 2003 to 2018 from 2 transplant centers in Veracruz, Mexico, was used. LKDPI was calculated in a webpage (www.transplantmodels.com). Donor and recipient demographics and transplant data included in the model were registered. Pearson correlation between the LKDPI percentage and death-censored graft survival was performed. Kaplan-Meier survival (log-rank) and Cox regression analysis were compared between the LKPDI quartiles. P < .05 was considered statistically significant.
Results: In total, 821 transplants were included (mean age 31.7 ± 10.5 years, 62.5% male, n = 513). Mean follow-up was 64.7 ± 46.2 months. Mean estimated survival (Kaplan-Meier) was 128.9 ± 3 months (95% confidence interval [CI], 123-134). Ten-year death-censored graft survival was 61.4%. Median LKPDI was -2%, and mean LKDPI was -2.6% ± 14.6% (range, -50% to 42%). Pearson coefficient correlation between the LKDPI and death-censored graft survival was 0.024 (P = .4). Area under the curve (receiver operating characteristic [ROC]) for the LKDPI and death-censored graft loss was 0.54 (95% CI, 0.505-0.591) (P = .04). Recipients with the lowest LKDPI had lower risk of death-censored graft loss than other quartiles (P = .014 log-rank). Cox regression analysis was significant for the lower LKDPI quartile (<20%) (Exp B = 0.35; 95% CI, 0.14-0.9; P = .03).
Conclusion: The LKDPI applies with moderate discrimination predictive power in our population. The best LKDPI patient has better death-censored graft survival. Further studies might continue to validate the LKDPI in other cohorts.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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