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The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants

The independent effects of deceased donor kidney length and vascular plaque on long-term graft survival are not established. Utilizing DonorNet attachments from 4,480 expanded criteria donors (ECD) recovered between 2008 and 2012 in the United States with at least one kidney biopsied and transplante...

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Autores principales: Tanriover, Bekir, Stewart, Darren, Kamal, Layla, Saeed, Muhammad, Cooper, Matthew, Foutz, Julia, McGehee, Harrison, Gupta, Gaurav
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10379651/
https://www.ncbi.nlm.nih.gov/pubmed/37519905
http://dx.doi.org/10.3389/ti.2023.11373
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author Tanriover, Bekir
Stewart, Darren
Kamal, Layla
Saeed, Muhammad
Cooper, Matthew
Foutz, Julia
McGehee, Harrison
Gupta, Gaurav
author_facet Tanriover, Bekir
Stewart, Darren
Kamal, Layla
Saeed, Muhammad
Cooper, Matthew
Foutz, Julia
McGehee, Harrison
Gupta, Gaurav
author_sort Tanriover, Bekir
collection PubMed
description The independent effects of deceased donor kidney length and vascular plaque on long-term graft survival are not established. Utilizing DonorNet attachments from 4,480 expanded criteria donors (ECD) recovered between 2008 and 2012 in the United States with at least one kidney biopsied and transplanted, we analyzed the relationship between kidney length and vascular plaques and 10-year hazard of all-cause graft failure (ACGF) using causal inference methods in a Cox regression framework. The composite plaque score (range 0–4) and the presence of any plaque (yes, no) was also analyzed. Kidney length was modeled both categorically (<10, 10–12, >12 cm) as well as numerically, using a restricted cubic spline to capture nonlinearity. Effects of a novel composite plaque score 4 vs. 0 (HR 1.08; 95% CI: 0.96, 1.23) and the presence of any vascular plaque (HR 1.08; 95% CI: 0.98, 1.20) were attenuated after adjustment. Likewise, we identified a potential nonlinear relationship between kidney length and the 10-year hazard of ACGF, however the strength of the relationship was attenuated after adjusting for other donor factors. The independent effects of vascular plaque and kidney length on long-term ECD graft survival were found to be minimal and should not play a significant role in utilization.
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spelling pubmed-103796512023-07-29 The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants Tanriover, Bekir Stewart, Darren Kamal, Layla Saeed, Muhammad Cooper, Matthew Foutz, Julia McGehee, Harrison Gupta, Gaurav Transpl Int Health Archive The independent effects of deceased donor kidney length and vascular plaque on long-term graft survival are not established. Utilizing DonorNet attachments from 4,480 expanded criteria donors (ECD) recovered between 2008 and 2012 in the United States with at least one kidney biopsied and transplanted, we analyzed the relationship between kidney length and vascular plaques and 10-year hazard of all-cause graft failure (ACGF) using causal inference methods in a Cox regression framework. The composite plaque score (range 0–4) and the presence of any plaque (yes, no) was also analyzed. Kidney length was modeled both categorically (<10, 10–12, >12 cm) as well as numerically, using a restricted cubic spline to capture nonlinearity. Effects of a novel composite plaque score 4 vs. 0 (HR 1.08; 95% CI: 0.96, 1.23) and the presence of any vascular plaque (HR 1.08; 95% CI: 0.98, 1.20) were attenuated after adjustment. Likewise, we identified a potential nonlinear relationship between kidney length and the 10-year hazard of ACGF, however the strength of the relationship was attenuated after adjusting for other donor factors. The independent effects of vascular plaque and kidney length on long-term ECD graft survival were found to be minimal and should not play a significant role in utilization. Frontiers Media S.A. 2023-07-14 /pmc/articles/PMC10379651/ /pubmed/37519905 http://dx.doi.org/10.3389/ti.2023.11373 Text en Copyright © 2023 Tanriover, Stewart, Kamal, Saeed, Cooper, Foutz, McGehee and Gupta. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Tanriover, Bekir
Stewart, Darren
Kamal, Layla
Saeed, Muhammad
Cooper, Matthew
Foutz, Julia
McGehee, Harrison
Gupta, Gaurav
The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants
title The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants
title_full The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants
title_fullStr The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants
title_full_unstemmed The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants
title_short The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants
title_sort independent effects of kidney length and vascular plaque on ten-year outcomes of extended criteria donor kidney transplants
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10379651/
https://www.ncbi.nlm.nih.gov/pubmed/37519905
http://dx.doi.org/10.3389/ti.2023.11373
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