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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 7/2018

Open Access 01-11-2018 | ORIGINAL ARTICLE

Development and validation of a prognostic model for kidney function 1 year after combined pancreas and kidney transplantation using pre-transplant donor and recipient variables

Authors: Katharina S. Zorn, Simon Littbarski, Ysabell Schwager, Alexander Kaltenborn, Jan Beneke, Jill Gwiasda, Thomas Becker, Felix Braun, Benedikt Reichert, Jürgen Klempnauer, Harald Schrem

Published in: Langenbeck's Archives of Surgery | Issue 7/2018

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Abstract

Purpose

The widening gap between demand and supply of organs for transplantation provides extraordinary challenges for ethical donor organ allocation rules. The transplant community is forced to define favorable recipient/donor combinations for simultaneous kidney-pancreas transplantation. The aim of this study is the development of a prognostic model for the prediction of kidney function 1 year after simultaneous pancreas and kidney transplantation using pre-transplant donor and recipient variables with subsequent internal and external validation.

Methods

Included were patients with end-stage renal failure due to diabetic nephropathy. Multivariable logistic regression modeling was applied for prognostic model design with retrospective data from Hannover Medical School, Germany (01.01.2000–31.12.2011) followed by prospective internal validation (01 Jan. 2012–31 Dec. 2015). Retrospective data from another German transplant center in Kiel was retrieved for external model validation via the initially derived logit link function.

Results

The developed prognostic model is able to predict kidney graft function 1 year after transplantation ≥ KDIGO stage III with high areas under the receiver operating characteristic curve in the development cohort (0.943) as well as the internal (0.807) and external validation cohorts (0.784).

Conclusion

The proposed validated model is a valuable tool to optimize present allocation rules with the goal to prevent transplant futility. It might be used to support donor organ acceptance decisions for individual recipients.
Appendix
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Metadata
Title
Development and validation of a prognostic model for kidney function 1 year after combined pancreas and kidney transplantation using pre-transplant donor and recipient variables
Authors
Katharina S. Zorn
Simon Littbarski
Ysabell Schwager
Alexander Kaltenborn
Jan Beneke
Jill Gwiasda
Thomas Becker
Felix Braun
Benedikt Reichert
Jürgen Klempnauer
Harald Schrem
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 7/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-018-1712-z

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