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The Kidney Donor Risk Index (KDRI) and Kidney Donor Profile Index (KDPI) have been developed to assess deceased-donor graft quality, although validation of their utility outside the USA remains limited. This single-center retrospective cohort study evaluated the ability of KDRI and KDPI to predict transplant outcomes in a Greek cohort. The efficacy of KDRI, KDPI, and donor's age in predicting death-censored graft failure was primarily assessed. Overall, 394 donors and 456 recipients were included. Death-censored graft survival was significantly worse with increasing KDRI (hazard ratio-HR: 2.21, 95% confidence intervals-CI: 1.16-4.22), KDPI (HR: 1.01, 95% CI: 1.00-1.02), and donor's age (HR: 1.03, 95% CI: 1.00-1.05). The unadjusted discriminative ability was similar for KDPI (C-statistic: 0.54) and donor's age (C-statistic: 0.52). The KDPI threshold of 85 was not predictive of graft failure (-value: 0.19). Higher KDPI was linked to delayed graft function and worse kidney function, but not among expanded-criteria donor transplantations. No significant association was found between KDRI, KDPI, and patient survival. In conclusion, increasing KDRI and KDPI are linked to worse graft function, although their ability to discriminate long-term graft failure remains limited.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10054426 | PMC |
http://dx.doi.org/10.3390/jcm12062439 | DOI Listing |
Am J Transplant
June 2025
Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.
This study reports the results of a recalculation of the kidney donor risk index (KDRI) formula requested by the Organ Procurement and Transplantation Network's Minority Affairs Committee to remove the donor race and hepatitis C virus (HCV) status variables. The updated KDRI model was fit on adult, deceased donor, solitary kidney, first-time transplants from 2018-2021. Deceased donors from 2018 through 2021 were included in a counterfactual analysis to evaluate how the kidney donor profile index (KDPI) would change if race and HCV seropositivity were excluded.
View Article and Find Full Text PDFRev Med Inst Mex Seguro Soc
March 2024
Secretaría de Salud, Hospital General de México "Dr. Eduardo Liceaga", Servicio de Trasplantes, Ciudad de México, México.
Background: Kidney transplant is the best replacement therapy for kidney function; However, donors are insufficient, so extended criteria donors (ECD) are needed, which, in well-selected recipients, provide better survival than being on dialysis. Dual kidney transplantation (DRT) should be offered to elderly patients with lower immunological risk and with a lower body mass index. DCE are considered donors who died due to stroke, ≥ 60 years old or aged between 50 and 59 years, with diabetes or previous hypertension, clinical proteinuria, estimated glomerular filtration rate (eGFR) between 30 and 60 mL/min, or Terminal serum creatinine > 2.
View Article and Find Full Text PDFBMC Med Ethics
October 2024
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Center for Academic Medicine, 453 Quarry Road, Room 267, MC 5661, Stanford, CA, 94304, USA.
Background: The Organ Procurement and Transplant Network (OPTN) Final Rule guides national organ transplantation policies, mandating equitable organ allocation and organ-specific priority stratification systems. Current allocation scores rely on mortality predictions.
Methods: We examined the alignment between the ethical priorities across organ prioritization systems and the statistical design of the risk models in question.
Clin Transplant
August 2024
Division of Transplantation & Hepatobiliary Surgery, Department of Surgery, University of California San Diego Health, La Jolla, California, USA.
Background: Efforts to address the shortage of donor organs include increasing the use of renal allografts from donors after circulatory death (DCD). While warm ischemia time (WIT) is thought to be an important factor in DCD kidney evaluation, few studies have compared the relationship between WIT and DCD kidney outcomes, and WIT acceptance practices remain variable.
Methods: We conducted a single-center retrospective review of all adult patients who underwent deceased donor kidney transplantation from 2000 to 2021.
Ann Transplant
August 2023
Organ and Tissue Transplant Unit, Clínica Imbanaco, Grupo Quirónsalud, Cali, Colombia.
BACKGROUND EPTS (Estimated Post-Transplant Survival), KDRI (Kidney Donor Risk Index), and KDPI (Kidney Donor Profile Index) were developed aiming to ameliorate donor-recipient longevity matching in kidney transplants. They are based on a prediction model made using the United States population; evidence of their use outside EEUU remains limited. The aim of this study was to describe the quality of deceased-donor kidneys and to determine recipient and graft survival, glomerular filtration rate, and incidence of delayed graft function in renal transplantation according to these indices in Cali, Colombia.
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