Korean J Transplant.  2022 Nov;36(Supple 1):S385. 10.4285/ATW2022.F-5250.

Impact of iliac artery calcification of deceased-donors on graft outcomes after kidney transplantation

• Oh YJ
• Jun H
• Kim MG
• Jung CW

• KMID: 2535219
• DOI: http://doi.org/10.4285/ATW2022.F-5250

Abstract

Background
The quality of deceased donors (DDs) kidney is closely related to graft survival after kidney transplantation (KT). Vascular calcification is a highly regulated, cell-mediated process associated with chronic kidney disease. The purpose of this study was to evaluate the predictability of vascular calcification in DD as determined by a computed tomography (CT) scanbased calcification scoring system and correlation with kidney biopsy scoring and graft outcomes.
Methods
A retrospective review of 147 DDs at Korea University Anam Hospital between 2010 and 2020 was performed. A total of 62 recipients with available pretransplant donors CT scan and time-zero biopsy (TZB) were included. Calcification length, circumference involvement, and morphology by iliac artery scoring system by Davis et al. (Figure) were scored and divided into moderate-to-severe (MTS) and non-to-mild (NTM). Calcification score, chronicity score of TZB, and baseline characteristics were collected and correlated with graft outcomes.
Results
In 62 recipients, MTS was 14 (22.6%) and NTM was 48 (77.4%). Mean age of MTS was higher (59.71±5.32 vs. 49.35±13.47, P=0.007). Diabetes mellitus (DM) were higher in MTS (6 [42.8%] vs. 7 [14.5%], P=0.032). MTS showed higher delay graft function (5 [35.7%] vs. 5 [10.4%], P=0.038). In severe TZB grading and biopsy-proven acute rejection, there were no statisti-cal differences (0 [0%] vs. 4 [8.3%], P=0.349; 4 (28.5%) vs. 16 (33.3%), P=0.505). Glomerular filtration rate of postoperative 1 year of MTS tended to be lower without statistical significance (42.95±14.92 vs. 48.53±18.33, P=0.318). One recipient of MTS experi-enced graft loss.
Conclusions
Vascular calcification in pretransplant CT scan is associated with old age and DM of DDs. No correlation was found between TZB grade and calcification. Vascular calcification is thought to be related to graft function after KT, and well-designed and long-term studies are needed.