MP61-05 UTILIZATION OF NOVEL TOOLS TO ASSESS RISK OF ESRD IN PATIENTS WHO UNDERWENT DONOR NEPHRECTOMY

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2018MP61-05 UTILIZATION OF NOVEL TOOLS TO ASSESS RISK OF ESRD IN PATIENTS WHO UNDERWENT DONOR NEPHRECTOMY Jason Scovell, Andre F. Perez-Orozco, Zachary McDowell, Nannan Thirumavalavan, Samit Soni, Wesley A. Mayer, and Richard E. Link Jason ScovellJason Scovell More articles by this author , Andre F. Perez-OrozcoAndre F. Perez-Orozco More articles by this author , Zachary McDowellZachary McDowell More articles by this author , Nannan ThirumavalavanNannan Thirumavalavan More articles by this author , Samit SoniSamit Soni More articles by this author , Wesley A. MayerWesley A. Mayer More articles by this author , and Richard E. LinkRichard E. Link More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1984AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Projecting the risk of a renal donor ultimately progressing to end stage renal disease (ESRD) is an essential component in determining donor suitability. Until recently, quantification of risk before and after surgery has been imprecise and subjective. Recently, modeling tools have been developed to predict the risk of ESRD in patients pre- and post-donor nephrectomy. We sought to determine the historical risk of ESRD in donors and to identify subpopulations with increased risk who underwent donor nephrectomy prior to the availability of these predictive models. METHODS Retrospective review of renal donors from several transplant centers was performed, and patients with all required data available for analysis were included. We calculated the pre-operative 15-year and lifetime risks using the ESRD Risk tool for Donor Candidates, and the 15- and 20-year risks using the Kidney Donor Risk tool. Comparisons of means were performed using a t-test and proportions using a Fisher exact test. RESULTS A total of 90 renal donors were included for analysis. The overall predicted pre- and post-operative 15-year risk of ESRD was generally very low at 0.095% +/- 0.088 and 0.161% +/- 0.170. Similarly, the predicted lifetime (pre-op) and 20-year risk (post-op) was favorable 0.483% +/- 0.331 and 0.336% +/- .350. Using the models, several patients were identified with an elevated risk (>1%) of ESRD. These patients were disproportionately African American (56% vs. 11% total, p<0.01) and were donating to first-degree relatives (100% vs. 44%, p<0.01). CONCLUSIONS Using previously unavailable tools to assess long-term ESRD risk in a historical renal donor population, we determined that the majority of patients who underwent surgery have a very low predicted risk of progression to ESRD. Renal donors with an elevated long-term risk are more likely to be African American and donating to first-degree family members. Long-term follow-up of outcomes will be valuable to assess the validity of these newly available risk-assessment models. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e825 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jason Scovell More articles by this author Andre F. Perez-Orozco More articles by this author Zachary McDowell More articles by this author Nannan Thirumavalavan More articles by this author Samit Soni More articles by this author Wesley A. Mayer More articles by this author Richard E. Link More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...