PMID- 27943514
OWN - NLM
STAT- MEDLINE
DCOM- 20180828
LR  - 20180828
IS  - 1440-1797 (Electronic)
IS  - 1320-5358 (Linking)
VI  - 23
IP  - 3
DP  - 2018 Mar
TI  - Living donor risk model for predicting kidney allograft and patient survival in 
      an emerging economy.
PG  - 279-286
LID - 10.1111/nep.12983 [doi]
AB  - AIM: Living donor kidney is the main source of donor organs in low to middle 
      income countries. We aimed to develop a living donor risk model that predicts 
      graft and patient survival in an emerging economy. METHODS: We used data from the 
      Sindh Institute of Urology and Transplantation (SIUT) database (n = 2283 
      recipients and n = 2283 living kidney donors, transplanted between 1993 and 2009) 
      and conducted Cox proportional hazard analyses to develop a composite score that 
      predicts graft and patient survivals. RESULTS: Donor factors age, creatinine 
      clearance, nephron dose (estimated by donor/recipient body weight ratio) and 
      human leukocyte antigen (HLA) match were included in the living donor risk model. 
      The adjusted hazard ratios (HRs) for graft failures among those who received a 
      kidney with living donor scores (reference to donor score of zero) of 1, 2, 3 and 
      4 were 1.14 (95%CI: 0.94-1.39), 1.24 (95%CI:1.03-1.49), 1.25 (95%CI:1.03-1.51) 
      and 1.36 (95%CI:1.08-1.72) (P-value for trend =0.05). Similar findings were 
      observed for patient survival. CONCLUSIONS: Similar to findings in high income 
      countries, our study suggests that donor characteristics such as age, nephron 
      dose, creatinine clearance and HLA match are important factors that determine the 
      long-term patient and graft survival in low income countries. However, other 
      crucial but undefined factors may play a role in determining the overall risk of 
      graft failure and mortality in living kidney donor transplant recipients.
CI  - (c) 2016 Asian Pacific Society of Nephrology.
FAU - Zafar, Mirza Naqi
AU  - Zafar MN
AD  - Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, 
      Pakistan.
FAU - Wong, Germaine
AU  - Wong G
AD  - Sydney School of Public Health, University of Sydney, Sydney, New South Wales, 
      Australia.
FAU - Aziz, Tahir
AU  - Aziz T
AD  - Department of Nephrology, Sindh Institute of Urology and Transplantation, 
      Karachi, Pakistan.
FAU - Abbas, Khawar
AU  - Abbas K
AD  - Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, 
      Pakistan.
FAU - Adibul Hasan Rizvi, S
AU  - Adibul Hasan Rizvi S
AD  - Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, 
      Pakistan.
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - Nephrology (Carlton)
JT  - Nephrology (Carlton, Vic.)
JID - 9615568
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Allografts
MH  - Databases, Factual
MH  - Decision Support Techniques
MH  - Developing Countries/*economics
MH  - *Donor Selection
MH  - Female
MH  - *Graft Survival
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Kidney Failure, Chronic/diagnosis/mortality/*surgery
MH  - Kidney Transplantation/adverse effects/*methods/mortality
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Pakistan/epidemiology
MH  - Postoperative Complications/mortality
MH  - Proportional Hazards Models
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - graft survival
OT  - kidney transplantation
OT  - living donor
OT  - patient
OT  - risk model
EDAT- 2016/12/13 06:00
MHDA- 2018/08/29 06:00
CRDT- 2016/12/13 06:00
PHST- 2016/09/29 00:00 [received]
PHST- 2016/12/06 00:00 [revised]
PHST- 2016/12/08 00:00 [accepted]
PHST- 2016/12/13 06:00 [pubmed]
PHST- 2018/08/29 06:00 [medline]
PHST- 2016/12/13 06:00 [entrez]
AID - 10.1111/nep.12983 [doi]
PST - ppublish
SO  - Nephrology (Carlton). 2018 Mar;23(3):279-286. doi: 10.1111/nep.12983.