The Association Between Kidney Donor Profile Index and 1-y Graft Function

Area of Science:

• Nephrology
• Transplant Surgery
• Immunology

Background:

• The Kidney Donor Profile Index (KDPI) is known to affect long-term kidney graft survival.
• However, its precise association with 1-year estimated glomerular filtration rate (eGFR) is less clear due to competing risks.

Purpose of the Study:

• To investigate the association between KDPI strata and 1-year eGFR in deceased donor kidney transplant recipients.
• To identify independent risk factors for lower kidney function at 1 year post-transplant.

Main Methods:

• A retrospective cohort study of 3059 deceased donor kidney transplant recipients with 1-year follow-up.
• Analysis of KDPI strata (0%-35%, 36%-50%, 51%-85%, 86%-100%) and 1-year eGFR using CKD-EPI equation.
• Cox regression and Poisson mediation analysis were employed.

Main Results:

• Incidence of delayed graft function and cytomegalovirus infection increased with higher KDPI.
• Median 1-year eGFR significantly decreased across increasing KDPI strata (P < 0.001).
• Higher KDPI, male donor sex, and longer cold ischemia time were independently associated with lower 1-year eGFR.

Conclusions:

• KDPI is a major independent risk factor for reduced 1-year kidney function in deceased donor kidney transplants.
• Cold ischemia time also significantly impacts early graft function.
• These findings emphasize the importance of donor characteristics and organ preservation in optimizing transplant outcomes.