Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation
Background. The Canadian Anatomic Kidney Score (CAKS) is a novel 6-point grading system that standardizes the gross description of a donor kidney across 3 components—vessels, anatomy, and sticky fat. We hypothesized that the CAKS predicts allograft functional outcomes and provides additional informa...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2024-04-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001604 |
| _version_ | 1797243081511141376 |
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| author | Danny Matti, BMSc, MD Juliano Offerni, MD Pavel S. Roshanov, MD Jirong Lu, MBBS Yanbo Guo, MD Victoria Lebedeva, MSc Erica Ai Li, BSc Haider Abed, BSc, MD William Luke, BSc, MD Alp Sener, MD Patrick P. Luke, MD |
| author_facet | Danny Matti, BMSc, MD Juliano Offerni, MD Pavel S. Roshanov, MD Jirong Lu, MBBS Yanbo Guo, MD Victoria Lebedeva, MSc Erica Ai Li, BSc Haider Abed, BSc, MD William Luke, BSc, MD Alp Sener, MD Patrick P. Luke, MD |
| author_sort | Danny Matti, BMSc, MD |
| collection | DOAJ |
| description | Background. The Canadian Anatomic Kidney Score (CAKS) is a novel 6-point grading system that standardizes the gross description of a donor kidney across 3 components—vessels, anatomy, and sticky fat. We hypothesized that the CAKS predicts allograft functional outcomes and provides additional information to the Kidney Donor Profile Index (KDPI) and histologic assessment of the donor kidney.
Methods. Single-center cohort of 145 patients who underwent renal transplantation with CAKS analysis between 2018 and 2021. CAKS was prospectively determined before transplantation. Preimplantation core biopsies were assessed according to the Remuzzi score (RS). The primary outcome was 1-y allograft function represented by an estimated glomerular filtration rate (eGFR).
Results. Linear regression without adjustment for KDPI or RS showed a significant association between the CAKS and 1-y eGFR (−8.7 mL/min/1.73 m2 per point increase in CAKS; 95% CI, −13.0 to −4.4; P < 0.001). Most of that association was attributed to the vessel component (−12.1; −19.4 to −4.8; P = 0.002). Adjustment for KDPI and RS attenuated the relationship between 1-y function and CAKS (−4.6; −9.5 to 0.3; P = 0.065) and vessel component (−7.4; −15.2 to 0.5; P = 0.068).
Conclusions. Anatomic assessment of donor kidneys at the time of transplantation associates with allograft function at 1 y. Vascular assessment appears to make the dominant contribution. |
| first_indexed | 2024-04-24T18:49:27Z |
| format | Article |
| id | doaj.art-4bc3b2dae6f94bcc999ae86e25c3bf1d |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-04-24T18:49:27Z |
| publishDate | 2024-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-4bc3b2dae6f94bcc999ae86e25c3bf1d2024-03-27T03:43:30ZengWolters KluwerTransplantation Direct2373-87312024-04-01104e160410.1097/TXD.0000000000001604202404000-00006Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for TransplantationDanny Matti, BMSc, MD0Juliano Offerni, MD1Pavel S. Roshanov, MD2Jirong Lu, MBBS3Yanbo Guo, MD4Victoria Lebedeva, MSc5Erica Ai Li, BSc6Haider Abed, BSc, MD7William Luke, BSc, MD8Alp Sener, MD9Patrick P. Luke, MD101 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.3 Maxy Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.4 Division of Urology, McMaster University, Hamilton, ON, Canada.2 London Health Sciences Centre, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.Background. The Canadian Anatomic Kidney Score (CAKS) is a novel 6-point grading system that standardizes the gross description of a donor kidney across 3 components—vessels, anatomy, and sticky fat. We hypothesized that the CAKS predicts allograft functional outcomes and provides additional information to the Kidney Donor Profile Index (KDPI) and histologic assessment of the donor kidney. Methods. Single-center cohort of 145 patients who underwent renal transplantation with CAKS analysis between 2018 and 2021. CAKS was prospectively determined before transplantation. Preimplantation core biopsies were assessed according to the Remuzzi score (RS). The primary outcome was 1-y allograft function represented by an estimated glomerular filtration rate (eGFR). Results. Linear regression without adjustment for KDPI or RS showed a significant association between the CAKS and 1-y eGFR (−8.7 mL/min/1.73 m2 per point increase in CAKS; 95% CI, −13.0 to −4.4; P < 0.001). Most of that association was attributed to the vessel component (−12.1; −19.4 to −4.8; P = 0.002). Adjustment for KDPI and RS attenuated the relationship between 1-y function and CAKS (−4.6; −9.5 to 0.3; P = 0.065) and vessel component (−7.4; −15.2 to 0.5; P = 0.068). Conclusions. Anatomic assessment of donor kidneys at the time of transplantation associates with allograft function at 1 y. Vascular assessment appears to make the dominant contribution.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001604 |
| spellingShingle | Danny Matti, BMSc, MD Juliano Offerni, MD Pavel S. Roshanov, MD Jirong Lu, MBBS Yanbo Guo, MD Victoria Lebedeva, MSc Erica Ai Li, BSc Haider Abed, BSc, MD William Luke, BSc, MD Alp Sener, MD Patrick P. Luke, MD Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation Transplantation Direct |
| title | Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation |
| title_full | Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation |
| title_fullStr | Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation |
| title_full_unstemmed | Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation |
| title_short | Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation |
| title_sort | canadian anatomic kidney score quantitative macroscopic assessment of donor kidney quality for transplantation |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001604 |
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