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Title: | External validation of the US and UK kidney donor risk indices for deceased donor kidney transplant survival in the Australian and New Zealand population. | Authors: | Clayton P.A.;Sypek M.P.;White S.;Chadban S.;Kanellis J.;Hughes P.;Dansie K.;Gulyani A.;McDonald S. | Monash Health Department(s): | Nephrology | Institution: | (Clayton, Dansie, Sypek, Chadban, Gulyani, McDonald) Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, SA, Adelaide, Australia (Clayton, McDonald) Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, SA, Adelaide, Australia (Clayton, McDonald) Adelaide Medical School, University of Adelaide, SA, Adelaide, Australia (Sypek, Hughes) Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sypek, Hughes) Department of Nephrology, Royal Melbourne Hospital, Melbourne, Australia (White, Chadban) Kidney Node, Charles Perkins Centre, University of Sydney, NSW, Sydney, Australia (Chadban) Department of Renal Medicine, Royal Prince Alfred Hospital, NSW, Sydney, Australia (Kanellis) Department of Nephrology, Monash, Health, Melbourne, VC, Australia (Kanellis) Department of Medicine, Centre for Inflammatory Diseases, Monash University, NSW, Melbourne, Australia | Issue Date: | 7-May-2020 | Copyright year: | 2019 | Publisher: | NLM (Medline) | Place of publication: | United Kingdom | Publication information: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 34 (12) (pp 2127-2131), 2019. Date of Publication: 01 Dec 2019. | Journal: | Nephrology Dialysis Transplantation | Abstract: | BACKGROUND: The US Kidney Donor Risk Index (KDRI) and the UK KDRI were developed to estimate the risk of graft failure following kidney transplantation. Neither score has been validated in the Australian and New Zealand (ANZ) population. METHOD(S): Using data from the Australia and New Zealand Organ Donor (ANZOD) and Dialysis and Transplant (ANZDATA) Registries, we included all adult deceased donor kidney-only transplants performed in ANZ from 2005 to 2016 (n=6405). The KDRI was calculated using both the US donor-only and UK formulae. Three Cox models were constructed (Model 1: KDRI only; Model 2: Model 1+transplant characteristics; Model 3: Model 2+recipient characteristics) and compared using Harrell's C-statistics for the outcomes of death-censored graft survival and overall graft survival. RESULT(S): Both scores were strongly associated with death-censored and overall graft survival (P<0.0001 in all models). In the KDRI-only models, discrimination of death-censored graft survival was moderately good with C-statistics of 0.63 and 0.59 for the US and UK scores, respectively. Adjusting for transplant characteristics resulted in marginal improvements of the US KDRI to 0.65 and the UK KDRI to 0.63. The addition of recipient characteristics again resulted in marginal improvements of the US KDRI to 0.70 and the UK KDRI to 0.68. Similar trends were seen for the discrimination of overall graft survival. CONCLUSION(S): The US and UK KDRI scores were moderately good at discriminating death-censored and overall graft survival in the ANZ population, with the US score performing slightly better in all models.Copyright © The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1093/ndt/gfz090 | PubMed URL: | 31157885 [http://www.ncbi.nlm.nih.gov/pubmed/?term=31157885] | ISSN: | 1460-2385 (electronic) | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/35534 | Type: | Article | Subjects: | United States incidence adult *adverse event Australia cadaver donor female graft rejection/di [Diagnosis] graft rejection/ep [Epidemiology] graft rejection/et [Etiology] *graft survival human kidney transplantation male middle aged New Zealand procedures proportional hazards model register risk assessment United Kingdom United States adverse event Australia cadaver donor graft rejection graft survival kidney transplantation New Zealand procedures proportional hazards register United Kingdom middle aged New Zealand procedures proportional hazards model register risk assessment United Kingdom donor cadaver Australia *adverse event adult United States female graft rejection / diagnosis / epidemiology / etiology *graft survival human incidence kidney transplantation male |
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