Clinical significance of the Kidney Donor Profile Index in deceased donors for prediction of post-transplant clinical outcomes: A multicenter cohort study

PLoS One. 2018 Oct 5;13(10):e0205011. doi: 10.1371/journal.pone.0205011. eCollection 2018.

Abstract

Background: We investigated whether the Kidney Donor Profile Index (KDPI) system is useful in predicting clinical outcomes in deceased donor kidney transplantation (DDKT).

Methods: Four hundred sixty-nine kidney transplant recipients (KTRs) receiving kidneys from 359 deceased donors were included in this study, which involved three transplant centers. KTRs were divided into high and low KDPI KTR groups based on the median KDPI score of 67%. We compared clinical outcomes between the high KDPI and low KDPI groups.

Results: There were no significant differences in the incidence of delayed graft function and acute rejection between high and low KDPI KTR groups. In comparison with histologic findings in allograft tissues obtained within three months from KT, the proportion of glomerulosclerosis was significantly higher in the high KDPI KTR group than in the low KDPI KTR group. With Kaplan-Meier analysis, the graft survival rate was significantly lower in the high KDPI KTR group than in the low KDPI KTR group (Log rank, P = 0.017), and multivariate analysis also demonstrated that a high KDPI score was a significant risk factor for death censored allograft failure (HR 2.62, 95% CI, 1.29-5.33, P = 0.008).

Conclusion: The KDPI scoring system is useful in predicting allograft outcomes in a Korean DDKT cohort.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Cohort Studies
  • Death*
  • Female
  • Graft Rejection / etiology
  • Graft Survival
  • Humans
  • Kidney Transplantation / adverse effects
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Tissue Donors / statistics & numerical data*

Grants and funding

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), and funded by the Ministry of Education, Science, and Technology (NRF-2017R1D1A1B03029140) and it was also supported by Research Fund of Seoul St. Mary's Hospital, The Catholic University of Korea. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.