TY - JOUR
T1 - Kidney donor profile index and post-transplant health care utilization
T2 - Implications for value of transplant care delivery
AU - Mour, Girish K.
AU - Chang, Yu Hui
AU - Calderon, Esteban
AU - Chang, James M.
AU - Velazco, Cristine S.
AU - Jadlowiec, Caroline C.
AU - Reddy, Kunam S.
AU - Heilman, Raymond L.
AU - Mathur, Amit K.
N1 - Funding Information:
The authors would like to acknowledge Katey Harris for assistance in dataset management. The study was funded with internal resources at Mayo Clinic. The authors declare no conflicts of interest. This research was made possible in part by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.
Publisher Copyright:
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2022/6
Y1 - 2022/6
N2 - Background: Centers discard high kidney donor profile index (KDPI) allografts, potentially related to delayed graft function and prolonged hospital use by kidney transplant recipients (KTR). We sought to determine whether high KDPI KTRs have excess health care utilization. Methods: We conducted a retrospective cohort study from a high-volume center analyzing KTRs from January 3, 2011 to April 12, 2015 (n = 652). We measured differences in hospital use, emergency visits, and outpatient visits within the first 90 days between low (≤85%) versus high KDPI (>85%) KTRs, as well as long-term graft function and patient survival. Results: High (n = 107) and low KDPI (n = 545) KTRs had similar length of stay (median = 3 days, P =.66), and readmission rates at 7, 30, and 90 days after surgery (all, P >.05). High KDPI kidneys were not associated with excess utilization of the hospital, emergency services, outpatient transplant clinics, or ambulatory infusion visits on univariate or multivariate analysis (all, P >.05). Low KDPI KTRs had significantly better eGFR at 2 years (Low vs. High KDPI: 60.35 vs. 41.54 ml/min, P <.001), but similar 3-year patient and graft survival (both, P >.09). Conclusions: High and low KDPI KTRs demonstrated similar 90-day risk-adjusted health care utilization, which should encourage use of high KDPI kidneys.
AB - Background: Centers discard high kidney donor profile index (KDPI) allografts, potentially related to delayed graft function and prolonged hospital use by kidney transplant recipients (KTR). We sought to determine whether high KDPI KTRs have excess health care utilization. Methods: We conducted a retrospective cohort study from a high-volume center analyzing KTRs from January 3, 2011 to April 12, 2015 (n = 652). We measured differences in hospital use, emergency visits, and outpatient visits within the first 90 days between low (≤85%) versus high KDPI (>85%) KTRs, as well as long-term graft function and patient survival. Results: High (n = 107) and low KDPI (n = 545) KTRs had similar length of stay (median = 3 days, P =.66), and readmission rates at 7, 30, and 90 days after surgery (all, P >.05). High KDPI kidneys were not associated with excess utilization of the hospital, emergency services, outpatient transplant clinics, or ambulatory infusion visits on univariate or multivariate analysis (all, P >.05). Low KDPI KTRs had significantly better eGFR at 2 years (Low vs. High KDPI: 60.35 vs. 41.54 ml/min, P <.001), but similar 3-year patient and graft survival (both, P >.09). Conclusions: High and low KDPI KTRs demonstrated similar 90-day risk-adjusted health care utilization, which should encourage use of high KDPI kidneys.
KW - KDPI
KW - health care utilization
KW - kidney transplant
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U2 - 10.1111/ctr.14618
DO - 10.1111/ctr.14618
M3 - Article
C2 - 35182437
AN - SCOPUS:85130226063
SN - 0902-0063
VL - 36
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 6
M1 - e14618
ER -