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Evolution of GFR Outcomes During the First Year of Transplant According to the Kidney Donor Risk Index Transplantation in México. The Experience of a Single Center

J. Aguilar-Frasco, J. Arreola-Guerra, L. Paláu, V. Visag, M. Vilatobá, A. Contreras, A. Sanchez, J. Alberu.

Transplantation, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México, DF, Mexico.

Meeting: 2015 American Transplant Congress

Abstract number: C53

Keywords: Glomerular filtration rate (GFR), Graft failure, Kidney transplantation

Session Information

Session Name: Poster Session C: ECD/DCD/high KDPI

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

 Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Several scoring systems have been proposed to evaluate the quality of kidneys from deceased donors (DD). Recently, Kidney Donor Risk Index (KDRI) was introduced in the USA as a refined version of the dichotomous extended criteria donor (ECD) score vs non-ECD. Objective:evaluate the usefulness of the KDRI as a tool risk predictor of graft loss, delayed graft function and clinical outcomes at one year post- transplant in patients with deceased donor kidney transplantation in our center. Methods: the information for this retrospective cohort study came from the data base of DD kidney transplants at our center. All patients included had at least one year of clinical follow up. Results: 96 patients transplanted from Jan/2008 to Nov/2013 with deceased kidney donors were included. They were on average 41.2 (+ 12.6) yo and 49(51%) were female. The donors had an average KDRI of 0.86 (ratio 0.58- 1.55). The variables and outcomes are presented in Table1.

Variable KDRI 0.5-0.74 (n=36) KDRI 0.75-0.99 (n=39) KDRI ≥1.0 (n=20) P
PRA CI 5.7(0-67) 8.6(0-91) 5(0-22) 0.71
PRA CII 5.69(0-86) 7.56(0-83) 6.25(0-86) 0.96
DSA 12(32.4%) 9(23%) 5(25%) 0.66
AR 17(45.9%) 18(46.1%) 12(60.0%) 0.54
DGF 0(0%) 7(18.4%) 6(30%) <0.01
GFR MO 1 69.9(21.2) 60.6(18.1) 50.7(26.9) <0.01
GFR MO 3 10.5(19.1) 58.9(21.2) 47.5(19.5) <0.01
GFR MO 6 67.8(20.4) 57.2(17.1) 45.1(18.6) <0.01
GFR MO 12 63.1(17.3) 57.7(17.7) 47.9(18.8) 0.012
GRAFT LOSS 0(0%) 3(7.69%) 2(10%) 0.177
Table1 Outcomes based on the different groups according to KDRI. PRA: Panel Reactive Antibodies, DSA: Donor Specific Antibodies, DGF: Delayed Graft Function, GFR (MDRD based), AR: Acute Rejection:borderline included.

Thirteen patients were classified as ECD according to traditional criteria. Three of them presented DGF (37.5 % VS 11.4% p=0.07). None of this patients presented graft loss at one year follow up.

Conclusions: The KDRI discriminated accordingly and in a significant manner patients with DGF and correlated with renal function from one mo to one year follow up. The correlation between the KDRI and the GFR was persistent and significant during the follow up. No differences were found in the episodes of acute rejection during the first year. KDRI it's a better prognostic tool when compared to other traditional criteria for evaluation of graft function during the first year post-transplant.

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To cite this abstract in AMA style:

Aguilar-Frasco J, Arreola-Guerra J, Paláu L, Visag V, Vilatobá M, Contreras A, Sanchez A, Alberu J. Evolution of GFR Outcomes During the First Year of Transplant According to the Kidney Donor Risk Index Transplantation in México. The Experience of a Single Center [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/evolution-of-gfr-outcomes-during-the-first-year-of-transplant-according-to-the-kidney-donor-risk-index-transplantation-in-mxico-the-experience-of-a-single-center/. Accessed May 17, 2025.

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