Kidney Week

Abstract: SA-PO061

Association Between Kidney Donor Risk of ESRD (KDRE) and Donor Selection/Deferral

Session Information

• Transplantation: Recipient and Donor Assessment
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Seth, Divya, UCSF, Berkeley, California, United States

Divya Seth,

• Milan, Jennifer Rose, UCSF, Berkeley, California, United States

Jennifer Rose Milan,

• Bae, Se ri, UCSF, Berkeley, California, United States

Se ri Bae,

• Johansen, Kirsten L., University of California, San Franicsco, San Francisco, California, United States

Kirsten L. Johansen,

• Lee, Brian K., University of California San Francisco, San Francisco, California, United States

Brian K. Lee,

• Adey, Deborah B., University of California, San Francisco, San Francisco, California, United States

Deborah B. Adey,

• Ku, Elaine, UCSF, Berkeley, California, United States

Elaine Ku,

Background

The Kidney Donor Risk of ESRD equation (KDRE) provides transplant centers a tool to assess the patient-specific risk of developing ESRD in living kidney donors based on age, sex, race, body mass index (BMI), and relationship to the recipient (http://www.transplantmodels.com/donesrd/). The goal of this study was to determine whether medical decisions surrounding donor eligibility align with the empirical KDRE predicted risk. We hypothesized that higher KDRE scores would be associated with a higher likelihood of donor deferral due to medical unsuitability.

Methods

The KDRE was determined by chart review of donor evaluations performed at a single center from 2009 - 2017 for a convenience sample of potential donors. The association between the 5-year predicted risk of ESRD and odds of deferral/acceptance was examined using unadjusted logistic models. Due to a lack of association between the KDRE score and donor deferral, we adjusted for factors within and outside of the KDRE (systolic BP, smoking) to determine which factors were most strongly associated with deferral from donation.

Results

313 donors had sufficient data to calculate the KDRE score. Mean age was 31±10 years and median BMI was 33. Evaluated donors were 49% White, 31% Hispanic, 6% Black; 44% male, and 52% of donors were related to the recipient. 34% of evaluated donors were deferred. There was no association between the KDRE predicted ESRD risk and donor deferral (Table), even after accounting for factors not in the KDRE score (systolic BP and smoking). When we adjusted for factors already in the KDRE score, older age was the only factor that was strongly associated with odds of deferral (OR 2.14 per 10-year increase in age [95% CI 1.48-3.10]).

Conclusion

We did not find the KDRE predicted ESRD risk to be associated with donor deferral or acceptance. Of the factors considered, older age was the strongest factor that was associated with donor deferral.

Funding

• NIDDK Support