Predictive value of aortoiliac calcification of deceased donors for chronicity score of allograft baseline biopsies and graft outcomes in kidney transplantation: a retrospective cohort study

초록

Purpose The quality of kidneys from deceased donors is critical for successful kidney transplantation. Due to donor shortages, expanded criteria donors are increasingly used, raising concerns about posttransplant outcomes. This study evaluated the predictive value of donor aortoiliac calcification on graft outcomes to improve donor assessment and transplant planning. Methods This retrospective study analyzed pretransplant non-contrast CT scans to classify donor aortoiliac calcification as non-to-mild or moderate-to-severe (MTS). Donor and recipient characteristics, time-zero biopsy findings, and graft outcomes were compared using chi-square tests and logistic regression. Results MTS donors were significantly older (58.2 ± 5.2 years vs. 49.7 ± 12.8 years, P = 0.002), had more diabetes mellitus (50.0% vs. 10.0%, P = 0.004), and higher Kidney Donor Profile Index (KDPI) scores (79.0 ± 15.2 vs. 59.4 ± 25.1, P = 0.001). Tubular atrophy (TA) was more frequent in the MTS group (81.8% vs. 46.7%, P = 0.022). Logistic regression showed donor diabetes mellitus (β = 0.496, P = 0.001) and Banff TA (β = 0.431, P = 0.003) were significant predictors of calcification. Conclusion Aortoiliac calcification in deceased donors is associated with older donor age, higher KDPI scores, and increased incidences of diabetes mellitus and TA. Although it correlated with donor-related risk factors known to influence graft outcomes, it did not independently predict graft function or survival. Therefore, its role in donor selection appears limited and warrants further validation through larger prospective studies.

키워드