Introduction: Due to a severe organ shortage, it is important to predict the outcome of grafts prior to kidney transplantation and establish an appropriate allocation system, particularly to consider expanded criteria donors from donors after cardiac death (DCD). This study evaluated the validity of the KDPI/KDRI for Japanese DCD and compared it with other risk factors.Methods: Since 1979, 541 kidneys were retrieved from 273 DCD donors using the in situ regional cooling technique. A total of 315 grafts were retrospectively assessed for the KDPI/KDRI. Results: The value of the KDPI had a markedly asymmetric distribution (mean of 84% vs. median of 94%). The value of the KDRI distributed high index rates (0.79-2.94: median 1.70). The overall 1-, 5-, 10- and 15-year graft survivals were 87.1%, 67.5%, 52.1% and 38.9%, respectively. The KDRI level correlated with the long-term graft survival. The 1-, 5-, 10- and 15-year graft survivals of the KDPI<1.2 were 98.0%, 87.7%, 73.5% and 59.2% vs. KDRI>2.0 of 81.3%, 55.0%, 34.7% and 22.1%, respectively. The warm ischemic time (WIT), donor gender and the era of transplantation were also assessed as potential risk factors for graft loss. A WIT >30 min. was identified as an independent risk factor for graft loss (p<0.001). Conclusions: Renal grafts recovered from DCD donors have a good renal function with an excellent long-term graft survival. The KDPI/KDRI is a good prognostic tool for the graft outcomes. However, the WIT should also be included in the allocation system for DCD.

CITATION INFORMATION: Kusaka M, Kawai A, Fukami N, Sasaki H, Takahashi H, Ito T, Kenmochi T, Shiroki R, Hoshinaga K. Adopting the Kidney Donor Profile Index (KDPI)/Kidney Donor Risk Index (KDRI) for Japanese Donors After Cardiac Death. Am J Transplant. 2016;16 (suppl 3).

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