Nomograms may help predict success of kidney transplants

New nomograms developed by Cleveland Clinic researchers could help predict the success of kidney transplants, according to a study that will be published in the March 2009 issue of the Journal of Urology.

David Goldfarb, MD, and colleagues analyzed data from the United Network for Organ Sharing registry to determine kidney function in transplant patients after 1 and 5 years. Researchers used the data to identify characteristics that have the most significant impact on outcomes following transplantation. Analyzed factors included the donor and recipient age, gender, and size. Using this information, they created nomograms that can be used in counseling recipients about which kidney donor will provide the best match.

“It’s our hope that this will lead to further individualization of care for kidney transplant recipients,” Dr. Goldfarb said. “When we’re better able to match donors and recipients prior to transplant, we can optimize outcomes and therefore reduce the likelihood that a patient will need another kidney in the next five years.”

In related news, a study has shown that kidney donors have survival rates similar to those of the general population (N Engl J Med 2009; 360:459-69).

A donor’s risk for developing end-stage renal disease, high blood pressure, diabetes, or cancer was found to be similar to that of a person of the same age, gender, and ethnicity who is not a donor. In addition, most donors had a preserved glomerular filtration rate, normal albumin excretion, and an excellent quality of life.

The study began in 1963 and was designed to examine the long-term outcomes of nearly 3,700 kidney donors at the University of Minnesota. From that group, researchers randomly chose 255 men and women to receive more detailed studies of kidney function, hypertension, general health status, and quality of life.

“A donor’s life span does not seem to be altered because of their donation, and risk of kidney failure is actually lower than what is reported in the general U.S. population,” said lead author Hassan Ibrahim, MD of the University of Minnesota, Minneapolis.

Results showed that 60% of donors have physical and mental health summary scores that are above the scores of the general population. That finding may be a direct consequence of the routine screening of donors for important health conditions at the time of donation, Dr. Ibrahim said.