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논문분류	춘계학술대회 초록집
제목	Estimating Donor Organ Quality with Baseline Histology and Kidney Donor Risk Index for Predicting Graft Outcomes in Deceased Donor Kidney Transplantation
저자	Kyung sun PARK1, Sang jun PARK2, Hojong PARK2, Misung KIM3, Jongha PARK1, Hyun chul CHUNG1, Hong rae CHO2, *Jong soo LEE1
출판정보	2017; 2017(1):
키워드	Deceased donor, kidney transplantation, baseline histology, kidney donor, kidney transplantation, baseline histology, kidney
초록	Objectives : Donor organ quality is a key determinant of graft outcomes in deceased donor kidney transplantation (DDKT). The effect of baseline histology at the time of transplantation and several donor quality scoring systems on long-term graft outcome has been evaluated but these results were debated. Methods : To investigate the predictive values of baseline histology and kidney donor risk index (KDRI) for graft outcome, we screened 167 patients who received DDKTs at Ulsan University Hospital from April 2003 to June 2016. Among them, 66 DDKTs who underwent baseline kidney biopsies and whose KDRIs were available were included in this analysis. All baseline biopsy was rescored according to the updated Banff classification. Results : Median follow-up was 22 months. Mean age of recipients and donors are 51.4 and 44.7 years, respectively. Mean kidney donor risk index (KDRI) was 1.40 ± 0.44. During follow up, delayed graft function (DGF) and biopsy proven acute rejection (BPAR) developed for 7 and 11 patients, respectively. Graft failure occurred to 2 patient and one of them showed 50% glomerulosclerosis (3/6), severe (>50%) interstitial fibrosis and severe (>50%) tubular atrophy who had failed graft at 8 days after DDKT for acute antibody-mediated rejection. In Cox-regression analysis, interstitial fibrosis/tubular atrophy (IFTA, HR=3.59, P=0.049) was a significant risk factor for BPAR. In multivariate linear regression, age (standardized beta[SB]=-0.282, P=0.002), BPAR (SB=-0.406, P<0.001), KDRI (SB=-0.277, P=0.003) and IFTA (SB=-0.298, P = 0.001) were significant predictors of last-vistit estimated glomerular filtration rate (eGFR). Conclusions : Several clinical and pathologic parameters such as KDRI and IFTA may be helpful for predicting allograft outcomes, including BPAR and lastvisit eGFR in DDKTs.
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