AUTHOR=Scurt Florian G. , Ernst Angela , FischerFröhlich Carl-Ludwig , Schwarz Anke , Becker Jan U. , Chatzikyrkou Christos 

TITLE=Performance of Scores Predicting Adverse Outcomes in Procurement Kidney Biopsies From Deceased Donors With Organs of Lower-Than-Average Quality

JOURNAL=Transplant International

VOLUME=Volume 36 - 2023

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.11399

DOI=10.3389/ti.2023.11399

ISSN=1432-2277

ABSTRACT=Several scores have been devised for providing a prognosis of outcomes after kidney transplantation. This study is a comprehensive test of these scores on a cohort of deceased donors with kidneys of lower-than-average quality and procurement biopsies. 
Fifteen scores were tested on a retrospective cohort consisting of 221 donors, 223 procurement biopsies, and 223 recipient records for performance on delayed graft function, graft function, or death-censored graft loss. 
The best performing score for DGF was the purely clinical of Chapal (AUC 0.709) followed by that of Irish (AUC 0.684); for graft function the Nyberg and for transplant loss the Snoeijs (AUC 0.630 and the Leuven scores (AUCs 0.637 and 0.620).
The only score with an acceptable performance was of Chapal. Its disadvantage is that knowledge of the cold ischemia time is required, which is not known at allocation. None of the other scores performed acceptably. The scores fared better in discarded than transplanted kidneys. Our study shows an unmet need for practical prognostic scores useful at the time of decision about discard or acceptance of deceased donor kidneys of lower-than-average-quality in the Eurotransplant consortium.