The Impact of the Kidney Allocation System on Outcomes for Kidneys with KDPI > 85%.

A. Perry,¹ J. Sageshima,¹ C. Santhanakrishnan,¹ J. McVicar,¹ C. Troppmann,¹ A. De Mattos,² J. Woloszyn,¹ R. Perez.¹

¹Division of Transplant Surgery, University of California, Davis, Sacramento, CA
²Division of Transplant Medicine, University of California, Davis, Sacramento, CA

Meeting: 2017 American Transplant Congress

Abstract number: A100

Keywords: Allocation, High-risk, Kidney transplantation, Resource utilization

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

Single center outcomes were examined to assess the impact of the implementation of the Kidney Allocation System (KAS) on outcomes for kidneys with KDPI >85%.

Methods: A retrospective analysis was performed for all kidney transplants performed at a single center using kidneys with KDPI > 85% between 3/2012 and 7/2016. Kidneys from donors < 20 kg were excluded. Recipient outcomes and donor characteristics for transplantations prior to KAS were compared to those after its implementation on Dec 4, 2014.

Results: Kaplan-Meier curves show no statistical difference in allograft survival. 6-month graft survival before and after KAS was 92.2% and 97.6%, respectively. Imports increased from 71% to 95% (p=.002). Cold ischemia time (CIT) was unchanged overall, but was lower in regional imports (Table 1). DCD donors increased from 13.7% to 38.1% (p=.007). Comparing a 20-month period before and after KAS, the rate of transplants of >85% KDPI kidneys increased (mean 1.3/month vs 2.5/month).

	Before KAS	After KAS	P value
N	51	42
Recipient Age (yrs)	64.2 ± 0.9	65.1 ± 1.2	P = 0.51
KDPI	92.2 ± 0.6	90.7 ±0.5	p=0.06
Imports	71%	95%	p = 0.022
Regional Imports	39%	48%	p=0.53
DCD %	13.7%	38.1%	p=0.007
DGF	27.5%	38.1%	p=0.27
6-month eGFR	45.7 ± 2.4	41.5 ± 2.8
CIT (hrs)	29.1 ± 1.7	30.0 ± 1.2	p = 0.68
CIT for regional imports (hrs)	31.7 ±1.6	26.3±1.6	p = 0.022
Transplants/month	1.3	2.5	p = 0.059

Conclusion: With implementation of KAS there was an increase in importation of high KDPI kidneys, and more efficient regional utilization suggested by improved CIT with regional imports. Graft survival was unchanged, and exceeded KDPI expected outcomes.

CITATION INFORMATION: Perry A, Sageshima J, Santhanakrishnan C, McVicar J, Troppmann C, De Mattos A, Woloszyn J, Perez R. The Impact of the Kidney Allocation System on Outcomes for Kidneys with KDPI > 85%. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Perry A, Sageshima J, Santhanakrishnan C, McVicar J, Troppmann C, Mattos ADe, Woloszyn J, Perez R. The Impact of the Kidney Allocation System on Outcomes for Kidneys with KDPI > 85%. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-the-kidney-allocation-system-on-outcomes-for-kidneys-with-kdpi-85/. Accessed May 25, 2025.

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