Estimating Donor Organ Quality with Baseline Histology and Kidney Donor Risk Index for Predicting Graft Outcomes in Deceased Donor Kidney Transplantation.

K. Park,¹ S. Park,² H. Park,² J. Park,¹ H. Chung,¹ M. Kim,³ H. Cho,² J. Lee.¹

¹Internal Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
²Surgery, Ulsan University Hospital, Ulsan, Republic of Korea
³Pathology, Ulsan University Hospital, Ulsan, Republic of Korea

Meeting: 2017 American Transplant Congress

Abstract number: A113

Keywords: Donors, Kidney transplantation, marginal

Session Information

Session Name: Poster Session A: Deceased Donor Issues I: Allocation, KDPI and Recipient Selection

Session Type: Poster Session

Date: Saturday, April 29, 2017

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall D1

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.

	Standardized Beta	P
Age at transplantation, per 1 year	-0.223	0.026
Biopsy-proven Acute Rejection	-0.414	<0.001
Kidney Donor Risk Index (KDRI)	-0.264	0.013
Interstitial Fibrosis and Tubular Atrophy (IFTA)	-0.266	0.009

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).

To cite this abstract in AMA style:

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. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/estimating-donor-organ-quality-with-baseline-histology-and-kidney-donor-risk-index-for-predicting-graft-outcomes-in-deceased-donor-kidney-transplantation/. Accessed May 11, 2025.

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