Chopra B, Sureshkumar KK. Kidney transplantation in older recipients: Preemptive high KDPI kidney vs lower KDPI kidney after varying dialysis vintage. World J Transplant 2018; 8(4): 102-109 [PMID: 30148076 DOI: 10.5500/wjt.v8.i4.102]
Corresponding Author of This Article
Kalathil K Sureshkumar, MD, Associate Professor, Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Allegheny Health Network, 320 East North Avenue, Pittsburgh, PA 15212, United States. kalathil.sureshkumar@ahn.org
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Aug 9, 2018; 8(4): 102-109 Published online Aug 9, 2018. doi: 10.5500/wjt.v8.i4.102
Kidney transplantation in older recipients: Preemptive high KDPI kidney vs lower KDPI kidney after varying dialysis vintage
Bhavna Chopra, Kalathil K Sureshkumar
Bhavna Chopra, Kalathil K Sureshkumar, Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, United States
Author contributions: Chopra B participated in literature search, data analysis and manuscript writing; Sureshkumar KK participated in literature search, data analysis and manuscript writing.
Institutional review board statement: The IRB has received this information and finds it qualifies for exempt status according to the following category in the code of regulations: 45 CFR 46.101 (b) Category (4) and with a “Waiver of HIPAA Authorization”.
Informed consent statement: Since the data set is de-identified, IRB exempted the study from requiring informed consent.
Conflict-of-interest statement: None.
Correspondence to: Kalathil K Sureshkumar, MD, Associate Professor, Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Allegheny Health Network, 320 East North Avenue, Pittsburgh, PA 15212, United States. kalathil.sureshkumar@ahn.org
Telephone: +1-412-3593319 Fax: +1-412-3594136
Received: April 10, 2018 Peer-review started: April 11, 2018 First decision: May 3, 2018 Revised: May 21, 2018 Accepted: May 30, 2018 Article in press: May 31, 2018 Published online: August 9, 2018 Processing time: 120 Days and 13.4 Hours
Core Tip
Core tip: Increasing waiting-time for deceased donor kidney (DDK) transplantation adversely impacts older patients disproportionately. Dialysis vintage and transplantation of “marginal kidneys” are associated with inferior post-transplant outcomes. Using OPTN/United Network for Organ Sharing database from 2001-2015, we compared the outcomes of preemptive transplantation of marginal [kidney donor profile index (KDPI) ≥ 85%] DDKs compared to transplanting better quality DDKs (KDPI 35%-84%) after being on dialysis for 1-4 and 4-8 years in patient > 60 years old. Preemptive transplantation of marginal kidneys provided non-inferior graft and patient outcomes compared to transplanting better quality kidneys in older patients on maintenance dialysis. Early transplantation could also provide quality of life and cost benefits.
