Date: Sunday, May 3, 2015
Session Name: Concurrent Session: Kidney Utilization/Center Issues
Session Time: 2:15pm-3:45pm
Presentation Time: 3:15pm-3:27pm
Location: Room 121-AB
BACKGROUND: Since 3/26/2012, the Kidney Donor Profile Index (KDPI), a percentile score reflecting donor-associated risk, has been provided with all deceased-donor kidney offers. We investigated whether discard rates changed after KDPI implementation.
METHODS: We studied kidneys recovered for transplantation between 3/26/2010-3/25/2012 (ECD era, N=28,636) and 3/26/2012-3/25/2014 (KDPI era, N=28,999) using SRTR data. We separately analyzed ECD-KDPI discordant kidneys, which were defined as ECD kidneys with KDPI≤75 (ECD/low-KDPI) or SCD kidneys with KDPI>85 (SCD/high-KDPI).
RESULTS: Both ECD and KDPI were associated with discard rate in both eras (Figure), but ECD was not significantly associated with discard when adjusted for KDPI. (OR=0.981.101.24, ECD era; 0.820.931.05, KDPI era) Using a generalized estimating equation, we did not observe a significant change in discard rate from ECD era to KDPI era among the entire population (aOR=0.981.041.10, p=0.2), or in any of the KDPI strata or the concordant kidneys. However, SCD/high-KDPI showed a significantly increased odds of discard (aOR=1.071.421.89, p=0.02) and ECD/low-KDPI showed a suggestive but not statistically significant decrease (aOR=0.570.771.04, p=0.1, Table).
CONCLUSION: Although the KDPI policy had minimal influence on overall discard, it may have increased the discard of SCD/high-KDPI kidneys. Special attention needs to be paid to this subgroup in organ allocation and clinical practice.
|ECD era (2010-2012)||KDPI era (2012-2014)||p-value|
|N||Discard rate||N||Discard rate||aOR|
|Highest- & lowest-risk|
|SCD & KDPI>85||643||46.2%||627||50.7%||1.071.421.89||0.02|
|ECD & KDPI≤75||1,018||23.2%||899||19.1%||0.570.771.04||0.1|
To cite this abstract in AMA style:Bae S, Massie A, Segev D. Discard of Kidneys at the Margin: ECD Versus KDPI Era [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/discard-of-kidneys-at-the-margin-ecd-versus-kdpi-era/. Accessed July 4, 2020.
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