Predicting post-surgery outcome after kidney transplantation by a comorbidity index

Background and aim: An easily accessible pre-transplant tool to better predict post-surgery outcome following kidney transplantation in elderly recipients is warranted.We investigated whether the Liu Comorbidity Index (LCI) may predict early admission to Intensive Care Unit (ICU) and post-operative mortality in kidney recipients ≥ 55 years of age.Patients and methods: Data from all patients ≥ 55 years who underwent kidney transplantation at our center from 2011-2015 were included.LCI consists of 11 comorbidity covariates creating a 21 point scale.A pre-transplant LCI was registered as the sum of the weights corresponding to the individual conditions present.Post-transplant survival data and ICU admission data were extracted from hospital records and from the Norwegian Renal Registry.Results: 639 recipients ≥ 55 years (mean age 66.0 ± 6.5) were analysed and their mean LCI score was 2.6 (± 2.4).98 recipients (15%) were admitted to the ICU during the early post-operative phase, and thirty-seven stayed more than 24hr.A LCI score ≥ 7 (p=0.002)and ICU stay ≥ 24 (p ≤ 0.001) hours were both independently associated with impaired patient survival.An elevated LCI score was associated with increased risk of admittance to the ICU (p=0.001)Conclusion: An elevated pre-transplant LCI score was associated with increased risk of ICU admission and impaired survival post kidney-transplantation in middleaged and elderly recipients.