Kidney Week

Abstract: SA-PO956

Adjusted Donor-Age (ADA) Score as a Tool for Characterizing Deceased Donor Kidneys: Multicentre Validation Study for a German Eurotransplant Cohort

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Mahler, Christoph Friedrich, Nierenzentrum Heidelberg eV, Heidelberg, Germany

Christoph Friedrich Mahler, DrMed

• Friedl, Felix, Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Felix Friedl

• Nusshag, Christian, Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Christian Nusshag, MD, DrMed

• Speer, Claudius, Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Claudius Speer

• Benning, Louise, Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Louise Benning, MD

• Schaier, Matthias, Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Matthias Schaier, MD, MBA

• Sommerer, Claudia, Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Claudia Sommerer, MD, MSc

• Mieth, Markus, Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany

Markus Mieth, MD, MBA

• Zeier, Martin G., Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Martin G. Zeier, MD, FASN

• Süsal, Can Cüneyt, Department of Nephrology, Klinikum Stuttgart, Stuttgart, Germany

Can Cüneyt Süsal

• Schwenger, Vedat, Department of Nephrology, Klinikum Stuttgart, Stuttgart, Germany

Vedat Schwenger, MD

• Morath, Christian, Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Christian Morath, MD

• Echterdiek, Fabian, Department of Nephrology, Klinikum Stuttgart, Stuttgart, Germany

Fabian Echterdiek, MD

• Kälble, Florian, Nierenzentrum Heidelberg eV, Heidelberg, Baden-Württemberg, Germany

Florian Kälble

Background

ADA adjusts the donor age according to risk factors (A: ADA<49, B: 50-59, C: 60-69, D: 70-79, E: >80 years) and stratifies the adjusted age into quintiles (A-C advantageous, D moderate, E unfavorable). The aim of this multicentre study is to explore, whether the ADA score can be validated for a Eurotransplant cohort.

Methods

We conducted a retrospective analysis of all kidney transplants from cadaveric donations at centers in Heidelberg, Stuttgart, and Munich (Technical University) between 2015 and 2021. Donor data were recorded using the Eurotransplant database to calculate the ADA score. The prognostic accuracy was assessed based on graft function after three months.

Results

Out of a total of 1353 transplanted kidneys, 1273 were included in the analysis. After three months, 924 (73%) recipients achieved an eGFR of >30 ml/min/1.75m². In 9% of the cases, graft failure occurred within the first three months. There was a significant correlation between higher ADA quintiles and poor transplant outcome (eGFR < 30 ml/min at 3 months in 10% (A), 14% (B), 24% (C), 39% (D), 46% (E) of patients; p<0.001). For patients with good graft function, the 3-month eGFR was associated with ADA (c-statistic = 0.66) and decreased with higher ADA quintiles (A: 60, B: 49, C: 43, D: 35, and E: 36 ml/min).

Conclusion

The ADA score proves to be a suitable, intuitive method for the evaluation grafts. Our multicentric analysis shows good predictive accuracy for graft function after three months. Although organs with an ADA over 80 years have an increased risk of graft failure, more than 50% of patients in this group show good graft function. Future studies should investigate this group in more detail to adapt the ADA score to the specific characteristics of the Eurotransplant donor pool.