Comparing Renal Function Recovery and Long Term Outcomes in Recipients of Standard and Expanded Criteria Donor Kidney Transplants.
McGill University Health Center, Montreal, Canada
Meeting: 2017 American Transplant Congress
Abstract number: D267
Keywords: Graft survival, Kidney transplantation, Renal function
Session Information
Session Name: Poster Session D: Long Term Kidney Outcomes
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Several donor and recipient characteristics are associated with adverse kidney transplantation (KT) outcomes. Our group has previously shown that based on the donor's terminal creatinine, one can estimate the recipient's renal function recovery (RFR) and this is assocuated with long-term graft survival. The aim of this study was to analyze the impact of RFR on 10-year graft outcomes by donor type [standard criteria donor (SCD) and expanded criteria donor (ECD)].
Methods: We conducted a retrospective analysis of all adult deceased-donor KT recipients at our center from January 1, 1996 to February 29, 2016. We excluded multiorgan and living donor transplants; 637 SCD and 426 ECD KT were eligible for analysis. Outcome of interest was death censored graft survival (DCGS). RFR was calculated using the formula = recipient eGFR/ (0.5*donor eGFR). Recipient eGFR was calculated using the CKD-EPI equation and three best creatinine values in the first 3 months. Donor eGFR was calculated using the terminal creatinine. DCGS was examined across three RFR thresholds <75%, 75-100% and >100%.
Results: Median donor eGFR was higher in the SCD group, 105.4 vs 93.3 mL/min/1.73 m2 in the ECD group. Median recipient eGFR was higher in the SCD group as well, 62.8 vs 45.8 mL/min/1.73 m2 in the ECD group. DGF rates were 23.1% in the SCD and 30.3% in the ECD group. A significantly higher number of SCD KT attained a higher RFR than the ECD KT (p<0.01). In the SCD and ECD groups, RFR of <75%, 75-100% and >100% was achieved by 15.4%, 16.0%, 68.6% and 25.1%, 22.3%, 52.6% of the recipients by 3-month post-KT, respectively. As shown in table 1, RFR< 75 was associated with poor DCGS in both SCD and ECD groups.
| Table 1: 10-year DCGS and RFR | ||
| SCD | ECD | |
| RFR <75% | ||
| 1-yr | 82% | 86% |
| 5-yr | 71% | 65% |
| 10-yr | 63% | 61% |
| RFR 75-100% | ||
| 1-yr | 94% | 90% |
| 5-yr | 89% | 82% |
| 10-yr | 76% | 68% |
| RFR>100% | ||
| 1-yr | 98% | 95% |
| 5-yr | 94% | 83% |
| 10-yr | 88% | 69% |
Conclusion: KT recipients whose 3-month RFR is <75% have a poor DCGS in both ECD and SCD cohorts and this association is more evident in the latter group.
CITATION INFORMATION: Sandal S, Cantarovich M, Paraskevas S, Almaghrawi N, Chaudhury P, Tchervenkov J. Comparing Renal Function Recovery and Long Term Outcomes in Recipients of Standard and Expanded Criteria Donor Kidney Transplants. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Sandal S, Cantarovich M, Paraskevas S, Almaghrawi N, Chaudhury P, Tchervenkov J. Comparing Renal Function Recovery and Long Term Outcomes in Recipients of Standard and Expanded Criteria Donor Kidney Transplants. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/comparing-renal-function-recovery-and-long-term-outcomes-in-recipients-of-standard-and-expanded-criteria-donor-kidney-transplants/. Accessed November 25, 2024.« Back to 2017 American Transplant Congress