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MTH score – A novel scoring system to risk stratify renal transplant cases and to improve outcomes post renal transplant

Login to Access Video or Poster Abstract: MP30-13
Sources of Funding: none

Introduction

ESRD is a highly prevalent cause of morbidity and mortality. Kidney transplantation is the optimal treatment of ESRD in terms of morbidity, mortality and quality of life. Maximum incidence of graft dysfunction in the first year post transplant. We wanted to study the pre and post transplant factors that can affect post transplant outcome and graft survival .We wanted to make a scoring system to predict outcomes post transplant.

Methods

450 cases of live donor renal transplant were studied in a period of 2 years . all recipients were followed for 1 year and their mean serum creatinine was considered to compare the outcomes post transplant . We studied the pre-transplant & post-transplant factors like donor age , donor sex , ratio of donor kidney weight to recipient body weight , recipient age , donor to recipient sex , cold ischemia time , time for diuresis , number of blood transfusions to recipient , amount of steroids taken by recipient in first 3 months after transplant , number of acute rejection episodes , number of renal arteries , hepatitis C virus infection of recipient . using these factors we made 3 score charts (pre transplant,post transplant & combined MTH score) by giving points in ascending order starting from 1 to each subgroup of the factors affecting transplant outcome . Maximum points were given to the category in the subgroup which has the best impact on the transplant outcome. We classified patients into low (score >30), intermediate risk (score 21-30) and high risk (score 11-20) . Independent t test or Mann Witney U test (*) was used as test of significance to identify the mean difference between two groups. ANOVA (Analysis of Variance) or Kruskal Wallis test (**) was the test of significance to identify the mean difference between more than two groups. p value <0.05 was considered as statistically significant.

Results

Overall 89.76% recipients had a serum creatinine of less than 2 at the end of one year_x000D_ 54.54 % recipients in MTH high risk group had serum creatinine < 2 at the end of 1 year._x000D_ 96.72 % recipients in MTH low risk group had serum creatinine < 2 at the end of 1 year _x000D_ 27.27% recipients in MTH high risk group were restarted on HD in the first year post renal transplant_x000D_

Conclusions

1.MTH score can help risk stratify renal transplant cases_x000D_ 2.The MTH score can help predict the outcomes in renal transplant _x000D_ 3.MTH score can be a guide for future scoring systems in transplant _x000D_ 4.Modifying the risk factors can help high risk cases to fall into low risk category and may improve post transplant graft survival rates in the first year ._x000D_

Funding

none

Authors
aditya yelikar
sachin joseph
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