Predicting How Well Kidney Transplant Patients Fare

Predicting How Well Kidney Transplant Patients Fare

by Brie Zeltner/Plain Dealer Reporter
Thursday January 22, 2009, 1:10 PM

Researchers at the Cleveland Clinic have developed a way of predicting how well kidney transplant patients fare based on the characteristics of the kidney donor.

The metric they have developed, called a nomogram, is a tool frequently used for cancer patients to predict risk and outcome after diagnosis.

This is the first of its kind for kidney transplant, though, said Dr. David Goldfarb, surgical director of the renal transplantation program at the Clinic and a lead author on the paper published today in the Journal of Urology.

"It's a function of how young the research (in this area) is," he said. "Transplantation is a relatively nascent science."

Goldfarb and a team at the Glickman Urological and Kidney Institute gathered data from more than 20,000 patients on the United Network for Organ Sharing (UNOS) registry and charted certain outcomes-- including renal function at one year and transplant success rate after five years--against a wide variety of donor characteristics.

They found that in general, the larger the kidney that's transplanted, the better the outcome for the patient.

The nomogram would be of most use in helping doctors or patients compare outcomes if they had more than one kidney to choose from. This situation is a rare "luxury" for most patients, however, the authors noted in the paper.

"It's better to get a kidney at all if you're on dialysis than to turn it down," Goldfarb said.

Still, he and the team at the Clinic believe that their tool will be useful for predicting outcomes for patients before transplants.

Between 14,000 and 16,000 kidney transplants are performed a year, on average, according to UNOS statistics. More than 76,000 people are currently waiting for a kidney transplant.

The team needs to finish statistical work on the model over the next few months before it becomes available to patients and doctors, Goldfarb said.

http://www.cleveland.com/medical/index.ssf/2009/01/researchers_at_the_cleveland_c.html