Donor Interstitial Fibrosis and Tubular Atrophy (IFTA) Are Not Independent Risk Factors for a Lower GFR at One Year.
Mayo Clinic, Phoenix.
Meeting: 2016 American Transplant Congress
Abstract number: C200
Keywords: Fibrosis, Glomerular filtration rate (GFR), Kidney transplantation
Session Information
Session Name: Poster Session C: Kidney Transplantation: AKI/Preservation/DCD
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background
Donor age is a determinant of allograft outcome after deceased donor kidney transplant (DDTx). Our aim was to determine if chronic changes on a reperfusion biopsy (Bx), after adjusting for donor age, provides any additional risk for a lower eGFR after DDTx.
Methods
All patients who received a DDTx between July 2003 and April 2015 were included if they had eGFR available 1 year post transplant. The primary outcome was eGFR by CKD-EPI at 1 year post DDTx. We used a logistic regression analysis to determine the interaction between donor age and Banff ci>0 and ct>0 on reperfusion Bx with the eGFR at 1 year. Continuous data shown as mean±SD.
Results
1054 patients received a DDTx during the study period. 708 (67.2%) had eGFR measurement available at 1 year. The eGFR for the entire group was 58.9±20.9 and 126 (17.8%) had eGFR < 40. A Bx was available in 79 (62.7%) of the low GFR group and 389 (66.8%) in the higher GFR group. Baseline characteristics are shown in table 1.
| eGFR<40(n=126) | eGFR≥40 (n=582) | P value | |
| Recipient age | 60.0±10.9 | 55.4±13.0 | 0.0002 |
| Recipient male | 60% | 56% | 0.41 |
| Recipient race Black | 11.9% | 8.4% | 0.23 |
| Recipient BMI | 29.3±5.2 | 29.3±5.6 | 0.92 |
| Recipient diabetic | 35% | 44% | 0.07 |
| HLA mismatch | 3.89±1.97 | 3.76±1.83 | 0.48 |
| Preemptive Tx | 22% | 13% | 0.01 |
| Donor terminal creatinine | 1.62±2.50 | 1.70±1.84 | 0.68 |
| KDPI | 0.69±0.25 | 0.46±0.27 | <.0001 |
| DCD donor | 4.8% | 11.9% | 0.01 |
| CIT | 16.8±6.8 | 17.3±7.8 | 0.46 |
| Donor age | 51.8±16.1 | 37.3±16.1 | <.0001 |
| Donor male | 51% | 63% | 0.01 |
On the univariate analysis, donor age, Bx ci>0 and Bx ct>0 were all associated with a significant higher risk of low eGFR at 1 year (table 2), however, after controlling for donor age, the Bx ci>0 and ct>0 were no longer significant.
| Univariate | Multivariate | |||||
| RR | 95% CI | P value | RR | 95% CI | P value | |
| Donor age (per year) | 1.05 | 1.04-1.07 | <.0001 | 1.05 | 1.03-1.07 | <.0001 |
| Bx ci>0 | 2.46 | 1.44-4.15 | 0.0012 | 1.03 | 0.51-2.10 | 0.94 |
| Bx ct>0 | 2.42 | 1.49-3.99 | 0.0004 | 1.40 | 0.72-2.67 | 0.32 |
We also compared the eGFR for the group with donor age ≥ 60 stratified by the Bx ci score (ci=0 vs ci>0) and the eGFR at 1 year was the same (44.1±18.4 vs 44.7±15.1, p=0.88). There were no differences in rejection or BK infection between the groups.
Conclusion
After adjusting for donor age, donor derived interstitial fibrosis and tubular atrophy is not independently associated with a lower GFR at 1 year.
CITATION INFORMATION: Heilman R, Qaqish I, Smith M, Khamash H, Kaplan B, Reddy K. Donor Interstitial Fibrosis and Tubular Atrophy (IFTA) Are Not Independent Risk Factors for a Lower GFR at One Year. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Heilman R, Qaqish I, Smith M, Khamash H, Kaplan B, Reddy K. Donor Interstitial Fibrosis and Tubular Atrophy (IFTA) Are Not Independent Risk Factors for a Lower GFR at One Year. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/donor-interstitial-fibrosis-and-tubular-atrophy-ifta-are-not-independent-risk-factors-for-a-lower-gfr-at-one-year/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress