Histopathological evaluation of pretransplant donor biopsies in expanded criteria donors with high kidney donor profile index: a retrospective observational cohort study
Summary There is no consensus on the allocation of renal transplants from expanded criteria donors (ECD). The Kidney Donor Profile Index (KDPI) is used without the need for pretransplant donor biopsies (PTDB). We explored whether PTDB based on Remuzzi Score (RS) allows identification of those margin...
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| Veröffentlicht in: | Transplant international 2017-10, Vol.30 (10), p.975-986 |
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| creator | Sánchez‐Escuredo, Ana Sagasta, Amaia Revuelta, Ignacio Rodas, Lida M. Paredes, David Musquera, Mireia Diekmann, Fritz Campistol, Josep M. Solé, Manel Oppenheimer, Federico |
| description | Summary
There is no consensus on the allocation of renal transplants from expanded criteria donors (ECD). The Kidney Donor Profile Index (KDPI) is used without the need for pretransplant donor biopsies (PTDB). We explored whether PTDB based on Remuzzi Score (RS) allows identification of those marginal kidneys in the highest calculated KDPI risk group (>91%) that appropriate for single transplantation. A retrospective study was conducted of 485 consecutive kidneys procured from a single center and transplanted if the RS was ≤4. We compared 5‐year kidney and patients survival between KDPI groups and between RS 91% calculated KDPI group, there were no differences in graft survival depending on the RS ( |
| doi_str_mv | 10.1111/tri.12966 |
| format | Article |
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There is no consensus on the allocation of renal transplants from expanded criteria donors (ECD). The Kidney Donor Profile Index (KDPI) is used without the need for pretransplant donor biopsies (PTDB). We explored whether PTDB based on Remuzzi Score (RS) allows identification of those marginal kidneys in the highest calculated KDPI risk group (>91%) that appropriate for single transplantation. A retrospective study was conducted of 485 consecutive kidneys procured from a single center and transplanted if the RS was ≤4. We compared 5‐year kidney and patients survival between KDPI groups and between RS <4 or =4 in the highest KDPI group. The median KDPI (interquartile range) was 71 (66–76) for KDPI <80% (n = 77), 86 (81–90) for KDPI 81–90% (n = 82), and 97 (94–100) for KDPI >91% (n = 205). Patient survival at 5 years was 85.7%, 85.3%, and 76.09% (P = 0.058) and death‐censored graft survival was 84.4%, 86.5%, 73.6% (P = 0.015), respectively for each KDPI group. In >91% calculated KDPI group, there were no differences in graft survival depending on the RS (<4 vs. =4) (P = 0.714). The implementation of PTDB based on RS used for allocation of organs with the highest KDPI range could support to the acceptance of suitable organs for single transplantation with good patient and graft survival rate.</description><identifier>ISSN: 0934-0874</identifier><identifier>EISSN: 1432-2277</identifier><identifier>DOI: 10.1111/tri.12966</identifier><identifier>PMID: 28403541</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; biopsies ; Biopsy ; Cohort analysis ; Criteria ; Delayed Graft Function - epidemiology ; expanded criteria donors ; Female ; Graft Rejection - epidemiology ; Graft Survival ; Grafting ; Humans ; Kidney - pathology ; kidney donor profile index ; Kidney transplantation ; Kidney Transplantation - mortality ; Kidneys ; Male ; Mathematical analysis ; Middle Aged ; Observational studies ; Organ donors ; Organs ; Retrospective Studies ; Spain - epidemiology ; Survival ; Tissue Donors ; Transplantation ; Transplants ; Transplants & implants ; Transplants - standards</subject><ispartof>Transplant international, 2017-10, Vol.30 (10), p.975-986</ispartof><rights>2017 Steunstichting ESOT</rights><rights>2017 Steunstichting ESOT.</rights><rights>Copyright © 2017 Steunstichting ESOT. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3886-6db5c83ee33d8354c40c46831386bcfc13ef23a1c17e50dd2e511208681134613</citedby><cites>FETCH-LOGICAL-c3886-6db5c83ee33d8354c40c46831386bcfc13ef23a1c17e50dd2e511208681134613</cites><orcidid>0000-0002-1401-2550</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftri.12966$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftri.12966$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28403541$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sánchez‐Escuredo, Ana</creatorcontrib><creatorcontrib>Sagasta, Amaia</creatorcontrib><creatorcontrib>Revuelta, Ignacio</creatorcontrib><creatorcontrib>Rodas, Lida M.</creatorcontrib><creatorcontrib>Paredes, David</creatorcontrib><creatorcontrib>Musquera, Mireia</creatorcontrib><creatorcontrib>Diekmann, Fritz</creatorcontrib><creatorcontrib>Campistol, Josep M.</creatorcontrib><creatorcontrib>Solé, Manel</creatorcontrib><creatorcontrib>Oppenheimer, Federico</creatorcontrib><title>Histopathological evaluation of pretransplant donor biopsies in expanded criteria donors with high kidney donor profile index: a retrospective observational cohort study</title><title>Transplant international</title><addtitle>Transpl Int</addtitle><description>Summary
There is no consensus on the allocation of renal transplants from expanded criteria donors (ECD). The Kidney Donor Profile Index (KDPI) is used without the need for pretransplant donor biopsies (PTDB). We explored whether PTDB based on Remuzzi Score (RS) allows identification of those marginal kidneys in the highest calculated KDPI risk group (>91%) that appropriate for single transplantation. A retrospective study was conducted of 485 consecutive kidneys procured from a single center and transplanted if the RS was ≤4. We compared 5‐year kidney and patients survival between KDPI groups and between RS <4 or =4 in the highest KDPI group. The median KDPI (interquartile range) was 71 (66–76) for KDPI <80% (n = 77), 86 (81–90) for KDPI 81–90% (n = 82), and 97 (94–100) for KDPI >91% (n = 205). Patient survival at 5 years was 85.7%, 85.3%, and 76.09% (P = 0.058) and death‐censored graft survival was 84.4%, 86.5%, 73.6% (P = 0.015), respectively for each KDPI group. In >91% calculated KDPI group, there were no differences in graft survival depending on the RS (<4 vs. =4) (P = 0.714). The implementation of PTDB based on RS used for allocation of organs with the highest KDPI range could support to the acceptance of suitable organs for single transplantation with good patient and graft survival rate.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>biopsies</subject><subject>Biopsy</subject><subject>Cohort analysis</subject><subject>Criteria</subject><subject>Delayed Graft Function - epidemiology</subject><subject>expanded criteria donors</subject><subject>Female</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Survival</subject><subject>Grafting</subject><subject>Humans</subject><subject>Kidney - pathology</subject><subject>kidney donor profile index</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - mortality</subject><subject>Kidneys</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Middle Aged</subject><subject>Observational studies</subject><subject>Organ donors</subject><subject>Organs</subject><subject>Retrospective Studies</subject><subject>Spain - epidemiology</subject><subject>Survival</subject><subject>Tissue Donors</subject><subject>Transplantation</subject><subject>Transplants</subject><subject>Transplants & implants</subject><subject>Transplants - standards</subject><issn>0934-0874</issn><issn>1432-2277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUFv1DAQhS0EokvhwB9AlrjAIa3HdhIvN1QVWqkSUtWeI8eeNC7ZONjOtvuT-i_xNgsHJHyZyzfP894j5D2wE8jvNAV3AnxdVS_ICqTgBed1_ZKs2FrIgqlaHpE3Md4zxrgq2WtyxJVkopSwIk8XLiY_6dT7wd85oweKWz3MOjk_Ut_RKWAKeozToMdErR99oK3zU3QYqRspPk56tGipCS5hcHphIn1wqae9u-vpT2dH3B12p-A7N2Betfj4hWq61_dxQpPcFqlvI4bt8-_5FON7HxKNaba7t-RVp4eI7w7zmNx-O785uyiufny_PPt6VRihVFVUti2NEohCWJU9GsmMrJQAoarWdAYEdlxoMFBjyazlWAJwpioFIGQF4ph8WnTzpb9mjKnZuGhwyP7Rz7EBlQPN-bI9-vEf9N7PIR-eqbWENdRC8Ux9XiiTfcaAXTMFt9Fh1wBr9v01ub_mub_Mfjgozu0G7V_yT2EZOF2Ahxzi7v9Kzc315SL5G7LHqIA</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Sánchez‐Escuredo, Ana</creator><creator>Sagasta, Amaia</creator><creator>Revuelta, Ignacio</creator><creator>Rodas, Lida M.</creator><creator>Paredes, David</creator><creator>Musquera, Mireia</creator><creator>Diekmann, Fritz</creator><creator>Campistol, Josep M.</creator><creator>Solé, Manel</creator><creator>Oppenheimer, Federico</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1401-2550</orcidid></search><sort><creationdate>201710</creationdate><title>Histopathological evaluation of pretransplant donor biopsies in expanded criteria donors with high kidney donor profile index: a retrospective observational cohort study</title><author>Sánchez‐Escuredo, Ana ; Sagasta, Amaia ; Revuelta, Ignacio ; Rodas, Lida M. ; Paredes, David ; Musquera, Mireia ; Diekmann, Fritz ; Campistol, Josep M. ; Solé, Manel ; Oppenheimer, Federico</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3886-6db5c83ee33d8354c40c46831386bcfc13ef23a1c17e50dd2e511208681134613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>biopsies</topic><topic>Biopsy</topic><topic>Cohort analysis</topic><topic>Criteria</topic><topic>Delayed Graft Function - epidemiology</topic><topic>expanded criteria donors</topic><topic>Female</topic><topic>Graft Rejection - epidemiology</topic><topic>Graft Survival</topic><topic>Grafting</topic><topic>Humans</topic><topic>Kidney - pathology</topic><topic>kidney donor profile index</topic><topic>Kidney transplantation</topic><topic>Kidney Transplantation - mortality</topic><topic>Kidneys</topic><topic>Male</topic><topic>Mathematical analysis</topic><topic>Middle Aged</topic><topic>Observational studies</topic><topic>Organ donors</topic><topic>Organs</topic><topic>Retrospective Studies</topic><topic>Spain - epidemiology</topic><topic>Survival</topic><topic>Tissue Donors</topic><topic>Transplantation</topic><topic>Transplants</topic><topic>Transplants & implants</topic><topic>Transplants - standards</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sánchez‐Escuredo, Ana</creatorcontrib><creatorcontrib>Sagasta, Amaia</creatorcontrib><creatorcontrib>Revuelta, Ignacio</creatorcontrib><creatorcontrib>Rodas, Lida M.</creatorcontrib><creatorcontrib>Paredes, David</creatorcontrib><creatorcontrib>Musquera, Mireia</creatorcontrib><creatorcontrib>Diekmann, Fritz</creatorcontrib><creatorcontrib>Campistol, Josep M.</creatorcontrib><creatorcontrib>Solé, Manel</creatorcontrib><creatorcontrib>Oppenheimer, Federico</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sánchez‐Escuredo, Ana</au><au>Sagasta, Amaia</au><au>Revuelta, Ignacio</au><au>Rodas, Lida M.</au><au>Paredes, David</au><au>Musquera, Mireia</au><au>Diekmann, Fritz</au><au>Campistol, Josep M.</au><au>Solé, Manel</au><au>Oppenheimer, Federico</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Histopathological evaluation of pretransplant donor biopsies in expanded criteria donors with high kidney donor profile index: a retrospective observational cohort study</atitle><jtitle>Transplant international</jtitle><addtitle>Transpl Int</addtitle><date>2017-10</date><risdate>2017</risdate><volume>30</volume><issue>10</issue><spage>975</spage><epage>986</epage><pages>975-986</pages><issn>0934-0874</issn><eissn>1432-2277</eissn><abstract>Summary
There is no consensus on the allocation of renal transplants from expanded criteria donors (ECD). The Kidney Donor Profile Index (KDPI) is used without the need for pretransplant donor biopsies (PTDB). We explored whether PTDB based on Remuzzi Score (RS) allows identification of those marginal kidneys in the highest calculated KDPI risk group (>91%) that appropriate for single transplantation. A retrospective study was conducted of 485 consecutive kidneys procured from a single center and transplanted if the RS was ≤4. We compared 5‐year kidney and patients survival between KDPI groups and between RS <4 or =4 in the highest KDPI group. The median KDPI (interquartile range) was 71 (66–76) for KDPI <80% (n = 77), 86 (81–90) for KDPI 81–90% (n = 82), and 97 (94–100) for KDPI >91% (n = 205). Patient survival at 5 years was 85.7%, 85.3%, and 76.09% (P = 0.058) and death‐censored graft survival was 84.4%, 86.5%, 73.6% (P = 0.015), respectively for each KDPI group. In >91% calculated KDPI group, there were no differences in graft survival depending on the RS (<4 vs. =4) (P = 0.714). The implementation of PTDB based on RS used for allocation of organs with the highest KDPI range could support to the acceptance of suitable organs for single transplantation with good patient and graft survival rate.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>28403541</pmid><doi>10.1111/tri.12966</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-1401-2550</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Transplant international, 2017-10, Vol.30 (10), p.975-986 |
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| subjects | Adult Aged Aged, 80 and over biopsies Biopsy Cohort analysis Criteria Delayed Graft Function - epidemiology expanded criteria donors Female Graft Rejection - epidemiology Graft Survival Grafting Humans Kidney - pathology kidney donor profile index Kidney transplantation Kidney Transplantation - mortality Kidneys Male Mathematical analysis Middle Aged Observational studies Organ donors Organs Retrospective Studies Spain - epidemiology Survival Tissue Donors Transplantation Transplants Transplants & implants Transplants - standards |
| title | Histopathological evaluation of pretransplant donor biopsies in expanded criteria donors with high kidney donor profile index: a retrospective observational cohort study |
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