Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation

Danny Matti, BMSc, MD; Juliano Offerni, MD; Pavel S. Roshanov, MD; Jirong Lu, MBBS; Yanbo Guo, MD; Victoria Lebedeva, MSc; Erica Ai Li, BSc; Haider Abed, BSc, MD; William Luke, BSc, MD; Alp Sener, MD; Patrick P. Luke, MD

doi:10.1097/TXD.0000000000001604

Transplantation Direct (Apr 2024)

Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation

Danny Matti, BMSc, MD,
Juliano Offerni, MD,
Pavel S. Roshanov, MD,
Jirong Lu, MBBS,
Yanbo Guo, MD,
Victoria Lebedeva, MSc,
Erica Ai Li, BSc,
Haider Abed, BSc, MD,
William Luke, BSc, MD,
Alp Sener, MD,
Patrick P. Luke, MD

Affiliations

Danny Matti, BMSc, MD: 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Juliano Offerni, MD: 3 Maxy Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Pavel S. Roshanov, MD: 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Jirong Lu, MBBS: 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Yanbo Guo, MD: 4 Division of Urology, McMaster University, Hamilton, ON, Canada.
Victoria Lebedeva, MSc: 2 London Health Sciences Centre, London, ON, Canada.
Erica Ai Li, BSc: 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Haider Abed, BSc, MD: 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
William Luke, BSc, MD: 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Alp Sener, MD: 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Patrick P. Luke, MD: 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

DOI: https://doi.org/10.1097/TXD.0000000000001604
Journal volume & issue: Vol. 10, no. 4
p. e1604

Abstract

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Background. The Canadian Anatomic Kidney Score (CAKS) is a novel 6-point grading system that standardizes the gross description of a donor kidney across 3 components—vessels, anatomy, and sticky fat. We hypothesized that the CAKS predicts allograft functional outcomes and provides additional information to the Kidney Donor Profile Index (KDPI) and histologic assessment of the donor kidney. Methods. Single-center cohort of 145 patients who underwent renal transplantation with CAKS analysis between 2018 and 2021. CAKS was prospectively determined before transplantation. Preimplantation core biopsies were assessed according to the Remuzzi score (RS). The primary outcome was 1-y allograft function represented by an estimated glomerular filtration rate (eGFR). Results. Linear regression without adjustment for KDPI or RS showed a significant association between the CAKS and 1-y eGFR (−8.7 mL/min/1.73 m2 per point increase in CAKS; 95% CI, −13.0 to −4.4; P < 0.001). Most of that association was attributed to the vessel component (−12.1; −19.4 to −4.8; P = 0.002). Adjustment for KDPI and RS attenuated the relationship between 1-y function and CAKS (−4.6; −9.5 to 0.3; P = 0.065) and vessel component (−7.4; −15.2 to 0.5; P = 0.068). Conclusions. Anatomic assessment of donor kidneys at the time of transplantation associates with allograft function at 1 y. Vascular assessment appears to make the dominant contribution.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

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