Propensity score-based comparison of the graft failure risk between kidney transplant recipients of standard and expanded criteria donor grafts: Toward increasing the pool of marginal donors

A. Querard; F Le Borgne; A Dion; Magali Giral; G Mourad; V Garrigue; L Rostaing; N Kamar; A Loupy; C Legendre; E Morelon; F Buron; Y Foucher; E Dantan

doi:10.1111/ajt.14651

Journal articles

Propensity score-based comparison of the graft failure risk between kidney transplant recipients of standard and expanded criteria donor grafts: Toward increasing the pool of marginal donors

A. Querard ^{1, 2} F Le Borgne ^{2, 3} A Dion ² Magali Giral ^{4, 5, 6, 7} G Mourad ⁸ V Garrigue ⁸ L Rostaing ^{9, 10} N Kamar ^{9, 10} A Loupy ^{11, 12, 13, 14} C Legendre ^{15, 12, 13, 14} E Morelon ^{12, 16} F Buron ^{12, 16} Y Foucher ^{2, 7} E Dantan ²

1 CHD Vendée - Hôpital Les Oudairies [La Roche sur Yon]

2 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch

3 IDBC/A2com [Pace, France]

4 LabEx TRANSPLANTEX [CHU de Nantes]

5 U1064 Inserm - CRTI - Centre de Recherche en Transplantation et Immunologie

6 ITUN - Institut de transplantation urologie-néphrologie

7 CHU Nantes - Centre hospitalier universitaire de Nantes

8 CHU - Hôpital Lapeyronie [Montpellier]

9 Hôpital de Rangueil

10 UT3 - Université Toulouse III - Paul Sabatier

11 CHU Necker - Enfants Malades [AP-HP]

12 Réseau CENTAURE

13 UPD5 - Université Paris Descartes - Paris 5

14 USPC - Université Sorbonne Paris Cité

15 Service de néphrologie adultes [CHU Necker]

16 Hôpital Edouard Herriot [CHU - HCL]

Abstract : From a prospective and multicentric French cohort, we proposed an external validation study for the expanded criteria donor (ECD), based on 4833 kidney recipients transplanted for the first time between 2000 and 2014. We estimated the subject- specific effect from a multivariable Cox model. We confirmed a 1.75-fold (95% confidence interval [CI] 1.53-2.00, P < .0001) increase in graft failure risk if a given patient received an ECD graft compared to a graft from a donor with standard criteria (standard criteria donor [SCD]). Complementarily, we estimated the population-average effect using propensity scores. We estimated a 1.34-fold (95% CI 1.09-1.64, P = .0049) increase in graft failure risk among ECD patients receiving an ECD graft compared to receiving a SCD graft. With a 10-year follow-up, it corresponded to a decrease of 8 months of the mean time to graft failure due to ECD transplantation (95% CI 2-14 months). The population-average relative risk due to ECD transplantation and the corresponding absolute effect seem finally not so high. Regarding the increase of quality of life in transplantation, our study constitutes an argument to extend the definition marginality by considering more grafts at high risk and thereby enlarging the pool of kidney grafts.

Keywords : graft survival epidemiology donors and donation: standard criteria donors and donation: extended criteria clinical research/practice kidney transplantation/nephrology organ procurement and allocation.

Document type :

Journal articles

Domain :

Life Sciences [q-bio] / Immunology

Complete list of metadata

https://www.hal.inserm.fr/hal-01881151
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Submitted on : Tuesday, September 21, 2021 - 7:39:08 PM
Last modification on : Monday, September 27, 2021 - 6:44:21 PM

Propensity score-based comparison of the graft failure risk between kidney transplant recipients of standard and expanded criteria donor grafts: Toward increasing the pool of marginal donors

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Propensity score-based comparison of the graft failure risk between kidney transplant recipients of standard and expanded criteria donor grafts: Toward increasing the pool of marginal donors

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