A Risk Index for Living Donor Kidney Transplantation
A Risk Index for Living Donor Kidney Transplantation
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DOI：
10.1111/ajt.13709
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发表时间：
2016-07-01
影响因子：
8.8
通讯作者：
Segev, D. L.
中科院分区：
文献类型：
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作者：
Massie, A. B.;Leanza, J.;Segev, D. L.
在多个活体肾脏捐赠者之间进行选择，或评估肾脏配对捐赠的报价可能具有挑战性，因为目前没有衡量活体捐赠者质量的指标。此外，一些死亡供体 (DD) 肾脏可能比一些活体供体肾脏产生更好的结果，但无法在相同范围内对它们进行比较。为了更好地为临床决策提供信息，我们使用 Cox 回归并根据受者特征进行调整，创建了与 DD KDPI 相同规模的活体肾捐献者概况指数 (LKDPI)。捐赠者年龄超过 50 岁（每 10 年风险比 [HR]=(1.15)1.24(1.33))、BMI 升高（每 10 单位 HR=(1.01)1.09(1.16))、非洲裔美国人 (HR=(1.15)1.25(1.37))、吸烟 (HR=(1.09)1.16(1.23))、以及ABO不相容（HR=（1.03）1.27（1.58））、HLA B（HR=（1.03）1.08（1.14））不匹配和DR（HR=（1.04）1.09（1.15））不匹配与活体供体移植后更大的移植物丢失风险相关（所有p
Choosing between multiple living kidney donors, or evaluating offers in kidney paired donation, can be challenging because no metric currently exists for living donor quality. Furthermore, some deceased donor (DD) kidneys can result in better outcomes than some living donor kidneys, yet there is no way to compare them on the same scale. To better inform clinical decision-making, we created a living kidney donor profile index (LKDPI) on the same scale as the DD KDPI, using Cox regression and adjusting for recipient characteristics. Donor age over 50 (hazard ratio [HR] per 10years=(1.15)1.24(1.33)), elevated BMI (HR per 10 units=(1.01)1.09(1.16)), African-American race (HR=(1.15)1.25(1.37)), cigarette use (HR= (1.09)1.16(1.23)), as well as ABO incompatibility (HR= (1.03)1.27(1.58)), HLA B (HR=(1.03)1.08(1.14)) mismatches, and DR (HR=(1.04)1.09(1.15)) mismatches were associated with greater risk of graft loss after living donor transplantation (all p