Author:
Coca Armando,Arias-Cabrales Carlos,Valencia Ana Lucía,Burballa Carla,Bustamante-Munguira Juan,Redondo-Pachón Dolores,Acosta-Ochoa Isabel,Crespo Marta,Bustamante Jesús,Mendiluce Alicia,Pascual Julio,Pérez-Saéz María José
Abstract
AbstractPre-transplant prognostic scores help to optimize donor/recipient allocation and to minimize organ discard rates. Since most of these scores come from the US, direct application in non-US populations is not advisable. The Survival Benefit Estimator (SBE), built upon the Estimated Post-Transplant Survival (EPTS) and the Kidney Donor Profile Index (KDPI), has not been externally validated. We aimed to examine SBE in a cohort of Spanish kidney transplant recipients. We designed a retrospective cohort-based study of deceased-donor kidney transplants carried out in two different Spanish hospitals. Unadjusted and adjusted Cox models were applied for patient survival. Predictive models were compared using Harrell’s C statistics. SBE, EPTS and KDPI were independently associated with patient survival (p ≤ 0.01 in all models). Model discrimination measured with Harrell’s C statistics ranged from 0.57 (KDPI) to 0.69 (SBE) and 0.71 (EPTS). After adjustment, SBE presented similar calibration and discrimination power to that of EPTS. SBE tended to underestimate actual survival, mainly among high EPTS recipients/high KDPI donors. SBE performed acceptably well at discriminating post-transplant survival in a cohort of Spanish deceased-donor kidney transplant recipients, although its use as the main allocation guide, especially for high KDPI donors or high EPTS recipients requires further testing.
Funder
Instituto de Salud Carlos III
FIS-FEDER
Redinren
Publisher
Springer Science and Business Media LLC
Reference40 articles.
1. Garcia-Garcia, G., Harden, P. & Chapman, J. The global role of kidney transplantation for the world kidney day steering committee 2012. Int. J. Organ. Transplant Med. 3(1), 1–8 (2012).
2. Gridelli, B. & Remuzzi, G. Strategies for making more organs available for transplantation. N. Eng. J. Med. 343(6), 404–410 (2000).
3. Lloveras, J., Arcos, E., Comas, J., Crespo, M. & Pascual, J. A paired survival analysis comparing hemodialysis and kidney transplantation from deceased elderly donors older than 65 years. Transplantation 99(5), 991–996 (2015).
4. Ojo, A. O. et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J. Am. Soc. Nephrol. 12(3), 589–597 (2001).
5. Grams, M. E. et al. Trends in the prevalence of reduced GFR in the United States: A comparison of creatinine- and cystatin C-based estimates. Am. J. Kidney Dis. 62(2), 253–260 (2013).
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