Optimal Timing of Serum Creatinine Measurement for KDPI Scoring to Predict Postoperative Renal Function in Deceased Donor Kidney Transplantation

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2024-07-01 DOI:10.1016/j.transproceed.2024.02.022

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引用次数: 0

Abstract

Introduction

The widely employed Kidney Donor Profile Index (KDPI) scoring system, designed for assessing deceased donors (DD), plays a pivotal role in predicting graft function post kidney transplantation (KT). Given the dynamic nature of renal function, including serum creatinine (sCr), in managing DDs, it remains uncertain optimal timing to use KDPI for assessing postoperative graft function.

Methods

In this retrospective review, we assessed 246 DDs who were managed within a donor management program from January 2010 to December 2021. We collected sCr values for KDPI scoring at admission, peak, and last measurements before KT. Recipient data included occurrence of slow graft function (SGF), delayed graft function (DGF), and glomerular filtration rate (GFR) at one-year post-transplantation (1 Y). Using Receiver Operating Characteristic (ROC) and Pearson correlation analyses, we explored correlations of KDPI score (admission, peak, last) with graft function (SGF, DGF, GFR 1 Y).

Results

The average age of DDs and recipients was 49.78 ± 13.37 and 52.54 ± 10.49 years, respectively, with mean KDPI values at admission, peak, and last measurements of 62.36 ± 25.44, 66.94 ± 24.73, and 63.75 ± 25.80. After transplantation, SGF was observed in 81 recipients (32.9%) and DGF in 32 (13.0%). For SGF, the Area Under the Curve (AUC) from ROC analysis were 0.684 (95% CI, 0.615-0.753; P < .001) at admission, 0.691 (0.623-0.759; P < .001) at peak, and 0.697 (0.630-0.765; P < .001) at the last measurement. In predicting DGF, the corresponding AUC values were 0.746 (0.661-0.831; P < .001) at admission, 0.724 (0.637-0.810; P < .001) at peak, and 0.721 (0.643-0.809; P < .001) at the last. Moreover, KDPI scores at all time points—admission, peak, and last—moderately correlated with GFR 1 Y (R = -0.426, -0.423, -0.417).

Conclusion

KDPI measurements at all time points, particularly admission, would be more effective in predicting DGF in DDKT.

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为 KDPI 评分测量血清肌酐的最佳时间，以预测死亡供体肾移植手术后的肾功能。

导言：被广泛使用的肾脏捐献者档案指数（KDPI）评分系统是专为评估已故捐献者（DD）而设计的，在预测肾移植（KT）术后移植物功能方面发挥着关键作用。鉴于肾功能（包括血清肌酐（sCr））在管理 DD 时的动态性质，使用 KDPI 评估术后移植物功能的最佳时机仍不确定：在这项回顾性研究中，我们对 2010 年 1 月至 2021 年 12 月期间在供体管理项目中接受管理的 246 例 DD 进行了评估。我们收集了入院时、高峰期和 KT 前最后一次测量的 sCr 值，用于 KDPI 评分。受者数据包括移植后一年（1 Y）出现的移植功能缓慢（SGF）、移植功能延迟（DGF）和肾小球滤过率（GFR）。通过接收者操作特征（ROC）和皮尔逊相关分析，我们探讨了 KDPI 评分（入院时、高峰时、最后一次）与移植物功能（SGF、DGF、GFR 1 Y）的相关性：DDs和受者的平均年龄分别为（49.78±13.37）岁和（52.54±10.49）岁，入院时、高峰期和最后一次测量的KDPI平均值分别为（62.36±25.44）分、（66.94±24.73）分和（63.75±25.80）分。移植后，81 名受者（32.9%）出现 SGF，32 名受者（13.0%）出现 DGF。对于 SGF，ROC 分析得出的曲线下面积（AUC）分别为：入院时 0.684（95% CI，0.615-0.753；P < .001），高峰时 0.691（0.623-0.759；P < .001），最后一次测量时 0.697（0.630-0.765；P < .001）。在预测 DGF 时，入院时相应的 AUC 值为 0.746 (0.661-0.831; P < .001)，高峰时为 0.724 (0.637-0.810; P < .001)，最后一次测量时为 0.721 (0.643-0.809; P < .001)。此外，所有时间点的 KDPI 评分--入院时、高峰期和最后一次--与 GFR 1 Y 中度相关（R = -0.426、-0.423、-0.417）：结论：在所有时间点（尤其是入院时）测量 KDPI 可更有效地预测 DDKT 的 DGF。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.