Date: Sunday, June 3, 2018
Session Time: 4:30pm-6:00pm
Presentation Time: 5:06pm-5:18pm
Location: Room 6E
The kidney donor profile index (KDPI) helps discern kidney function. While recipients must consent for KDPI >85% kidneys, clinicians often decide whether to accept KDPI 71-85% offers, specifically for young, healthy patients. Older patients with prolonged wait times have been shown to benefit from these kidneys; yet other patients may face equipoise or harm. We sought to analyze the effect of accepting a kidney with KDPI 71-85% versus waiting for a better offer among different age, diabetic and wait time cohorts.
The SRTR database was used to analyze first-time recipients of solitary, kidney-only cadaveric renal transplants from 2006-2016. Using time-dependent regression, an exposed cohort of patients who received KDPI 71-85% transplants (higher KDPI) were compared to a cohort who either remained on the waitlist, or received KDPI <71% transplants. Patients were followed until death, graft failure, or the end of the study period. Subgroup analysis was performed among different age, wait time and diabetic cohorts. A cumulative ratio analysis was used to assess the hazard associated with higher KDPI transplant in specific scenarios.
237,541 patients were included in the study. There was a significantly decreased risk of death or graft failure over the study period in the higher KDPI cohort (HR 0.394, p<0.001). This benefit remained true over all age, diabetic, and wait time subgroups. Cumulative ratio analysis failed to demonstrate a scenario where a conservative approach showed benefit over higher KDPI transplantation.
Among all analyzed scenarios, recipients benefit from higher KDPI transplantation. Practitioners should consider transplanting these kidneys rather than waiting for better offers.
CITATION INFORMATION: Grodstein E., Yang J., Nair V., Molmenti E., Teperman L. The Benefit of Higher KDPI Renal Transplantation over Waiting for a Better Offer Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Grodstein E, Yang J, Nair V, Molmenti E, Teperman L. The Benefit of Higher KDPI Renal Transplantation over Waiting for a Better Offer [abstract]. https://atcmeetingabstracts.com/abstract/the-benefit-of-higher-kdpi-renal-transplantation-over-waiting-for-a-better-offer/. Accessed April 19, 2019.
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