Validation of Kidney Donor Profile Index and Estimated Post-Transplant Survival Scores in an Eastern European Transplantation Center-A Seven-Year Retrospective Observational Study.

The Kidney Donor Profile Index (KDPI) is an important metric for evaluating the quality of donor kidneys and predicting post-transplant outcomes. The Estimated Post-Transplant Survival (EPTS) score is a tool for estimating kidney transplant candidates' long-term survival. However, their validity in Eastern European cohorts is yet to be explored. This study aimed to evaluate the predictive accuracy of the KDPI and EPTS in a local cohort. We conducted a seven-year retrospective observational study at a high-volume transplant center in Romania. Data from 353 patients who received kidney transplants from brain-dead donors (DBDs) between 2017 and 2023 were analyzed. The KDPI scores were stratified into <35%, 35-85%, and >85%, while EPTS was stratified into <20%, 20-60%, and >60%. Primary outcomes included one-, three-, and five-year post-transplant graft function as estimated by eGFR, while secondary outcomes involved patient and graft survival rates at one, three, and five years. Graft function and survival rates were significantly lower with increasing KDPI and EPTS scores, reinforcing the utility of both scores in clinical decision-making. Despite their limitations, KDPI and EPTS remain valuable predictors in our patient population.