Background: Donor organ quality is a key determinant of graft outcomes in deceased donor kidney transplantation (DDKT). The effect of baseline histology at the time of transplantation and several donor quality scoring systems on long-term graft outcome has been evaluated but these results were debated.

Methods: To investigate the predictive values of baseline histology and kidney donor risk index (KDRI) for graft outcome, we screened 167 patients who received DDKTs at Ulsan University Hospital from April 2003 to June 2016. Among them, 66 DDKTs who underwent baseline kidney biopsies and whose KDRIs were available were included in this analysis. All baseline biopsy was rescored according to the updated Banff classification.

Results:Median follow-up was 18.5 months. Mean age of recipients and donors are 51.4 and 44.7 years, respectively. Mean kidney donor risk index (KDRI) was 1.40±0.44. During follow up, delayed graft function (DGF) and biopsy-proven acute rejection (BPAR) developed for 6 and 11 patients, respectively. Graft failure occurred to only 1 patient at 8 days after DDKT for acute antibody-mediated rejection, and the baseline biopsy showed 50% glomerulosclerosis (3/6), severe (>50%) interstitial fibrosis and severe (>50%) tubular atrophy. In multivariate linear regression, age (standardized beta[SB]=-0.223, P=0.026), BPAR (SB=-0.414, P<0.001), KDRI (SB=-0.264, P=0.013) and interstitial fibrosis/tubular atrophy (IFTA, SB=-0.266, P=0.009) were significant predictors of last-vistit estimated glomerular filtration rate.

Conclusion: Several clinical and pathologic parameters such as KDRI and IFTA may be helpful for predicting allograft outcomes in DDKTs.

CITATION INFORMATION: Park K, Park S, Park H, Park J, Chung H, Kim M, Cho H, Lee J. Estimating Donor Organ Quality with Baseline Histology and Kidney Donor Risk Index for Predicting Graft Outcomes in Deceased Donor Kidney Transplantation. Am J Transplant. 2017;17 (suppl 3).

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