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Development of an objective, standardized tool for surgical assessment of deceased donor kidneys: the Cambridge Kidney Assessment Tool

Ayorinde, John O.O., Hamed, Mazin, Goh, Mingzheng Aaron, Summers, Dominic M., Dare, Anna, Chen, Yining and Saeb-Parsy, Kourosh (2020) Development of an objective, standardized tool for surgical assessment of deceased donor kidneys: the Cambridge Kidney Assessment Tool. Clinical Transplantation, 34 (2). ISSN 0902-0063

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Identification Number: 10.1111/ctr.13782

Abstract

Quality assessment in kidney transplantation involves inspection to identify negative markers of organ quality. However, there is a paucity of evidence guiding surgical appraisal, and currently there is no evidence to differentiate important features from those that can be safely ignored. We propose a method to standardize surgical assessment and derived a simple rule to rapidly identify kidneys suitable for transplantation. Donor and recipient data were recorded alongside clinical outcomes in a prospectively maintained database. We developed a proforma (Cambridge Kidney Assessment Tool, CKAT) and used it to assess deceased donor kidney transplants. Factors predictive of utilization were identified by multivariate and univariate logistic regression analysis of CKAT-assessment scores, and test performance was evaluated using standard 2 × 2 contingency tables. Ninety-seven kidneys were included at a single center (2013-2014), and 184 CKAT assessments were performed. A CKAT threshold of “Carrell + Perfusion >3” was highly specific (99%) and performed favorably to consultant opinion (specificity 95%). 96% of the kidneys implanted in accordance with the rule survived to 1 year (mean eGFR 45.3 mL/min/1.73 m2). To our knowledge, this is the first attempt to objectively define macroscopic features that are relevant to kidney utilization. Common language could support training in organ assessment and ultimately help address unnecessary discard of donor kidneys.

Item Type: Article
Official URL: https://onlinelibrary.wiley.com/journal/13990012
Additional Information: © 2020 John Wiley & Sons A/S
Divisions: Statistics
Subjects: R Medicine > RD Surgery
Date Deposited: 30 Mar 2020 15:36
Last Modified: 30 May 2020 23:12
URI: http://eprints.lse.ac.uk/id/eprint/103893

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