High KDPI Kidneys (>85%) Do Not Adversely Affect HRQOL After Kidney Transplantation.
Vanderbilt University Medical Center, Nashville, TN.
Meeting: 2016 American Transplant Congress
Abstract number: 564
Keywords: Donors, Kidney transplantation, marginal, Outcome, Quality of life
Session Information
Session Name: Concurrent Session: The High KDPI Kidney: Outcomes and Optimal Utilization
Session Type: Concurrent Session
Date: Tuesday, June 14, 2016
Session Time: 4:30pm-6:00pm
Presentation Time: 5:30pm-5:42pm
Location: Ballroom C
Background. Since December 2014, deceased donor kidneys are allocated based on a kidney donor profile index (KDPI) by four sequences, A thru D. Estimated kidney graft survival rates decrease with increasing KDPI and utilizing a KDPI sequence D (>85%) kidney requires informed consent. While post-transplant improvement in health-related quality of life (HRQOL) has been widely reported, the effect of KDPI sequence on HRQOL has not been studied. The purpose of this study is to assess whether donor kidney quality, as reflected in KDPI sequence, is related to post-transplant HRQOL and its trajectory.
Methods. Longitudinal HRQOL was measured using the eight scales and physical (PCS) and mental (MCS) component summaries of the SF-36 Health Survey. KDPI values were stratified as sequence A (≤20%), B (21-34%), C (35-85%), or D (>85%). Multivariable linear mixed effects models that adjusted for gender, age, rejection, and re-transplantation, tested the effect of KDPI sequence on post-transplant HRQOL and its trajectory.
Results. The sample included 505 recipients transplanted from 1/2006 to 6/2014 with a total of 1580 discrete HRQOL measurements (mean 3±2, range 1-10 per patient). Follow-up time at the last HRQOL determination averaged 42±28 (range <1-111) months. Average post-transplant PCS (41±11) and MCS (51±11) scores were within general population norms (40-60). There was no effect of KDPI sequence on post-transplant HRQOL (all p>0.134) or its trajectory (p>0.163) as measured by the PCS, MCS or the eight SF-36 scales.
| Multivariate Models of Post-Transplant PCS and MCS | ||||
| PCS | MCS | |||
| Estimate | p-value | Estimate | p-value | |
| Male (ref:female) | 1.44 | 0.109 | 0.87 | 0.314 |
| Age (years) | -0.06 | <0.001 | -0.02 | 0.188 |
| No rejection proximal to HRQOL (ref:rejection) | -1.10 | 0.623 | 5.15 | 0.019 |
| No re-transplant (ref:re-transplant) | 0.23 | 0.908 | -0.01 | 0.994 |
| Time post-transplant at HRQOL (months) | -0.01 | 0.799 | -0.12 | 0.030 |
| KDPI Sequence (ref:D) A | -1.22 | 0.686 | 0.08 | 0.182 |
| B | -2.13 | 0.494 | 0.08 | 0.166 |
| C | 0.73 | 0.805 | 0.08 | 0.149 |
| Time by KDPI sequence interaction | 0.472 | 0.548 | ||
| Intercept | 45.88 | <0.001 | 47.07 | <0.001 |
Conclusion. Although increasing KDPI is associated with reduced graft survival, it does not adversely affect patient-reported HRQOL after kidney transplantation. This finding may be reassuring to patients and transplant centers when considering using high KDPI kidneys and may promote expanded use of this donor pool.
CITATION INFORMATION: Forbes R, Feurer I, LaNeve D, Gamble C, Shaffer D. High KDPI Kidneys (>85%) Do Not Adversely Affect HRQOL After Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Forbes R, Feurer I, LaNeve D, Gamble C, Shaffer D. High KDPI Kidneys (>85%) Do Not Adversely Affect HRQOL After Kidney Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/high-kdpi-kidneys-85-do-not-adversely-affect-hrqol-after-kidney-transplantation/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress