دورية أكاديمية
Development and external validation study combining existing models and recent data into an up-to-date prediction model for evaluating kidneys from older deceased donors for transplantation.
| العنوان: | Development and external validation study combining existing models and recent data into an up-to-date prediction model for evaluating kidneys from older deceased donors for transplantation. |
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| المؤلفون: | Ramspek CL; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: c.l.ramspek@lumc.nl., El Moumni M; Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Wali E; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands., Heemskerk MBA; Research Division, Dutch Transplant Foundation, Leiden, the Netherlands., Pol RA; Department of Surgery-Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Crop MJ; Department of Internal Medicine-Nephrology, University Medical Center Groningen, Groningen, the Netherlands., Jansen NE; Research Division, Dutch Transplant Foundation, Leiden, the Netherlands., Hoitsma A; Research Division, Dutch Transplant Foundation, Leiden, the Netherlands., Dekker FW; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands., van Diepen M; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands., Moers C; Department of Surgery-Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. |
| المصدر: | Kidney international [Kidney Int] 2021 Jun; Vol. 99 (6), pp. 1459-1469. Date of Electronic Publication: 2020 Dec 16. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 0323470 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1523-1755 (Electronic) Linking ISSN: 00852538 NLM ISO Abbreviation: Kidney Int Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2016- : New York : Elsevier Original Publication: New York, Springer-Verlag. |
| مواضيع طبية MeSH: | Kidney Transplantation*/adverse effects , Tissue Donors*, Graft Survival ; Humans ; Kidney ; Netherlands/epidemiology ; Treatment Outcome ; United States/epidemiology |
| مستخلص: | With a rising demand for kidney transplantation, reliable pre-transplant assessment of organ quality becomes top priority. In clinical practice, physicians are regularly in doubt whether suboptimal kidney offers from older donors should be accepted. Here, we externally validate existing prediction models in a European population of older deceased donors, and subsequently developed and externally validated an adverse outcome prediction tool. Recipients of kidney grafts from deceased donors 50 years of age and older were included from the Netherlands Organ Transplant Registry (NOTR) and United States organ transplant registry from 2006-2018. The predicted adverse outcome was a composite of graft failure, death or chronic kidney disease stage 4 plus within one year after transplantation, modelled using logistic regression. Discrimination and calibration were assessed in internal, temporal and external validation. Seven existing models were validated with the same cohorts. The NOTR development cohort contained 2510 patients and 823 events. The temporal validation within NOTR had 837 patients and the external validation used 31987 patients in the United States organ transplant registry. Discrimination of our full adverse outcome model was moderate in external validation (C-statistic 0.63), though somewhat better than discrimination of the seven existing prediction models (average C-statistic 0.57). The model's calibration was highly accurate. Thus, since existing adverse outcome kidney graft survival models performed poorly in a population of older deceased donors, novel models were developed and externally validated, with maximum achievable performance in a population of older deceased kidney donors. These models could assist transplant clinicians in deciding whether to accept a kidney from an older donor. (Copyright © 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: adverse outcome; graft failure; kidney allocation; kidney transplantation; mortality; prediction model |
| تواريخ الأحداث: | Date Created: 20201219 Date Completed: 20210624 Latest Revision: 20210624 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.kint.2020.11.016 |
| PMID: | 33340517 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1523-1755 |
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| DOI: | 10.1016/j.kint.2020.11.016 |