Assessing the Validity of the Kidney Donor Profile Index (KDPI): The MedStar Washington Hospital Center Experience
Transplantation Services, MedStar Washington Hospital Center, Washington, DC
MedStar Health Research Institute, Washington, DC
Meeting: 2013 American Transplant Congress
Abstract number: C1278
Introduction: Kidney allocation policy is controversial, but it his hoped that the Kidney Donor Profile Index (KDPI) and Estimated Post-Transplant Survival (EPTS) will allow for more efficient allocation of kidneys, and longer graft survival. Kidneys with lower KDPI are believed to have better survival than those with higher KDPI.
Objective: This study assesses whether KDPI is associated with graft failure, mortality and rejection among renal allograft recipients at the MedStar Washington Hospital Center (MWHC).
Methods: The KDPI scores were provided for deceased donor (DD) kidneys transplanted into 467 kidney allograft recipients at WHC from 2002-2011. Outcomes were tracked for graft and patient survival, and frequency of rejection. Considering KDPI of 0-20% as referent group, adjusted HRs were calculated.
Results: Recipients with higher KDPI were older, but more often first transplants. There was no difference in gender and race. As compared with KDPI of 0-20%, KDPI of >80%-100% was associated with higher risk of graft failure (HR, 2.94; 95% CI, 1.12-7.74). KDPI was not significantly associated with patient mortality or rejection.
| KDPI | |||||
| 0-20% (n=61) | >20-40% (n=78) | >40-60% (n=103) | >60-80% (n=106) | >80-100% (n=119) | |
| Graft Failure | |||||
| Univariate model | 1 (referent) | 1.43(0.56-3.65) | 1.70(0.70-4.14) | 1.10(0.43-2.80) | 2.29(0.97-5.39) |
| Multivariate model 1 • | 1 (referent) | 1.42(0.51-3.98) | 1.69(0.63-4.52) | 1.38(0.52-3.72) | 2.75(1.07-7.12) |
| Multivariate model 2 • • | 1 (referent) | 1.42(0.51-4.01) | 1.71(0.64-4.57) | 1.39(0.52-3.74) | 2.68(1.03-6.95) |
| Patient Mortality | |||||
| Univariate model | 1 (referent) | 0.91(0.30-2.70) | 0.45(0.13-1.61) | 0.93(0.33-2.63) | 2.11(0.84-5.31) |
| Multivariate model 1 • | 1 (referent) | 0.74(0.24-2.32) | 0.35(0.09-1.41) | 0.88(0.30-2.55) | 1.66(0.64-4.31) |
| Multivariate model 2 • • | 1 (referent) | 0.77(0.25-2.42) | 0.35(0.09-1.41) | 0.92(0.32-2.68) | 1.58(0.61-4.11) |
| Rejection | |||||
| Univariate model | 1 (referent) | 0.58(0.30-1.14) | 0.89(0.50-1.60) | 0.72(0.40-1.31) | 1.21(0.70-2.10) |
| Multivariate model 1 • | 1 (referent) | 0.53(0.25-1.11) | 0.74(0.38-1.44) | 0.51(0.25-1.03) | 1.37(0.73-2.56) |
| Multivariate model 2 • • | 1 (referent) | 0.53(0.25-1.12) | 0.75(0.38-1.47) | 0.51(0.25-1.04) | 1.35(0.72-2.54) |
Conclusion: KDPI was associated with graft failure, but not mortality or rejection, suggesting it is a valuable decision-making tool for DD kidney allocation.
To cite this abstract in AMA style:
Orquiza M, Tucker M, Wang H, Light J. Assessing the Validity of the Kidney Donor Profile Index (KDPI): The MedStar Washington Hospital Center Experience [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/assessing-the-validity-of-the-kidney-donor-profile-index-kdpi-the-medstar-washington-hospital-center-experience/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress