It might be difficult to predict the results of borderline kidney transplants. The related risk ratings included donor creatinine or estimated glomerular filtration rate (eGFR). But it’s unclear which of their values, acquired consecutively throughout procurement, is the most appropriate.
The study involved transplanting 221 adult brain-dead donors with subpar kidneys into 223 recipients. The relationship between initial (at hospital admission), nadir (lowest), zenith (highest), and terminal (at recovery) donor eGFR and primary non-function, delayed graft function, 3- and 12-month graft function, and 1- and 3-year patient- and death-censored graft survival was examined using logistic regression analysis.
In the multivariate study, the lowest donor eGFR, admission, and terminal were the variables that predicted DGF the most precisely. The corresponding ORs (within the 95% CI) were: 0.875 (0.771-0.993), 0.818 (0.726-0.922), and 0.793 (0.689-0.900). The greatest eGFR was the strongest predictor of 3-month graft performance, although it was not significant for DGF (OR 0.931 [95% CI: 0.817-1.106]). The adjusted b coefficient was 1.161 [95% CI: 0.355-1.968]. Analysis of the main nonfunction revealed that the greatest eGFR and initial determination were the strongest predictors. The corresponding ORs (95% CI) were 0.750 [0.611-0.919] and 0.804 [0.667-0.968]. The risk correlations of the four eGFR recordings with the patient- and graft survival were identical.
The various eGFR measurements made while marginal donors were being procured can forecast PNF, DGF, and 3- and 12-month graft function. In terms of short-term patient- and transplant survival, recipient parameters rather than donor kidney function seemed to have an influence.
Reference: onlinelibrary.wiley.com/doi/10.1111/nep.14108
