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External validation of the US and UK kidney donor risk indices for deceased donor kidney transplant survival in the Australian and New Zealand population

Nephrology Dialysis Transplantation Dec 11, 2019

Clayton PA, Dansie K, Sypek MP, et al. - Given that the US Kidney Donor Risk Index (KDRI) and the UK KDRI, tools developed to determine graft failure risk post-renal transplantation, have not been verified in the Australian and New Zealand (ANZ) population, therefore, researchers performed this study with 6,405 adult deceased donor kidney-only transplants done in ANZ from 2005 to 2016, and used data from the Australia and New Zealand Organ Donor (ANZOD) and Dialysis and Transplant (ANZDATA) Registries. Employing both the US donor-only and UK formulae, they calculated the KDRI. They developed three Cox models (Model 1: KDRI only; Model 2: Model 1 + transplant characteristics; Model 3: Model 2 + recipient features) and performed comparisons using Harrell’s C-statistics focusing on the results of death-censored graft survival and overall graft survival. Findings revealed moderately good performance of the US and UK KDRI scores in differentiating death-censored and overall graft survival in the ANZ population. In all models, a slightly better performance of the US score was observed.
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