Assessment of kidney quality before harvesting. Review of contemporary donor risk indexes

Abstract

One of the key issues in contemporary transplantology is an objective assessment of a kidney donor to be performed before accepting the organ for transplantation. There have been various attempts at creating a numerical scale, based on donor, recipient, histological or machine perfusion parameters, to evaluate the quality of kidneys harvested from cadaver donors. Some of these were based on large populations of donor-recipient pairs and have been accepted by local organ allocation systems. As of yet none has been endorsed by international institutions a universal predictive model of graft function nor provided a uniform platform to initiate and to compare clinical studies. Originally proposed by Rao et al in 2009, the Kidney Donor Risk Index (KDRI) is a prediction model that assigns a continuous risk score to deceased donor kidneys, based on a donor and a transplant characteristics collected by the Organ Procurement and Transplantation Network (OPTN). The new kidney allocation system implemented in the US rates the harvested organs, based on KDRI. So far, few publications covered an assessment of the importance of risk KDRI for population recipients in other countries and it is also not known whether it is also an adequate prognostic tool for polish population of recipients.