Predicting 5-year survival after kidney transplantation in Colombia using the survival benefit estimator tool.

IntroductionA complex relationship between donor and recipient characteristics influences kidney transplant (KT) success. A tool developed by Bae S. et al. (Survival Benefit Estimator, SBE) helps estimate post-KT survival. We aim to evaluate the predictive performance of the SBE tool in terms of 5-year patient survival after a kidney transplant.MethodsA retrospective cohort study of all deceased-donor KT recipients between January 2009 to December 2021. A descriptive analysis of clinical and sociodemographic characteristics was performed. The SBE online tool was used to calculate the predicted patient survival (PPS) and the survival benefit at five years post-KT. Comparisons between predictive vs. actual patient survival were made using quintile subgroups. Three Cox regression models were built using PPS, EPTS, and KDPI.ResultsA total of 1145 recipients were evaluated. Mortality occurred in 157 patients. Patient survival was 86.2%. Predictive survival for patients if they remained on the waiting list was 70.6%. The PPS was 89.3%, which results in a survival benefit (SB) of 18.7% for our population. Actual survival rates were lower than the predicted ones across all the quintiles. In unadjusted analysis, PPS was a significant protective factor for mortality (HR 0.66), whereas EPTS (HR 8.9) and KDPI (HR 3.25) scores were significant risk factors. The discrimination of KDPI, PPS, and EPTS scores models were 0.59, 0.65, and 0.66, respectively.ConclusionSBE score overestimated actual survival rates in our sample. The discrimination power of the score was moderate, although the utility of this tool may be limited in this specific population

Liver Transplantation in Latin America: the State-of-the-Art and Future Trends

We reviewed the current status of liver transplantation in Latin America. We used data from the Latin American and Caribbean Transplant Society and national organizations and societies, as well as information obtained from local transplant leaders. Latin America has a population of 589 million (8.5% of world population) and more than 2,500 liver transplantations are performed yearly (17% of world activity), resulting in 4.4 liver transplants per million people (pmp) per year. the number of liver transplantations grows at 6% per year in the region, particularly in Brazil. the top liver transplant rates were found in Argentina (10.4 pmp), Brazil (8.4 pmp), and Uruguay (5.5 pmp). the state of liver transplantation in some countries rivals those in developed countries. Model for End-Stage Liver Disease-based allocation, split, domino, and living-donor adult and pediatric transplantations are now routinely performed with outcomes comparable to those in advanced economies. in contrast, liver transplantation is not performed in 35% of Latin American countries and lags adequate resources in many others. the lack of adequate financial coverage, education, and organization is still the main limiting factor in the development of liver transplantation in Latin America. the liver transplant community in the region should push health care leaders and authorities to comply with the Madrid and Istambul resolutions on organ donation and transplantation. It must pursue fiercely the development of registries to advance the science and quality control of liver transplant activities in Latin America.Hosp Israelita Albert Einstein, São Paulo, BrazilNorthwestern Univ, Chicago, IL 60611 USAUniv São Paulo, São Paulo, BrazilInst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, MexicoIrmandade Santa Casa Misericordia Porto Alegre, Porto Alegre, RS, BrazilHosp Britan, Buenos Aires, DF, ArgentinaUniversidade Federal de São Paulo, São Paulo, BrazilColombiana Transplantes, Bogota, ColombiaCtr Estadual Transplante, Rio de Janeiro, BrazilMt Sinal Recanatti Miller Transplant Inst, New York, NY USAYale Univ, Sch Med, New Haven, CT USAFdn Vale Lilli, Cali, ColombiaUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc