Background The Kidney Donor Profile Index (KDPI) is an excellent tool to provide the clinician with a more comprehensive and continuous estimate of donor quality. Very young and/or small donors can have high KDPI values due to smaller kidney size and less renal mass. Our goal was to assess the graft survival of adult recipients of solitary kidneys from pediatric donors and compared them to the estimated outcomes based on the respective KDPI values.

Methods A retrospective review was performed for all adult transplant recipients of a solitary pediatric kidney (age < 18 years) between August 2005 and June 2012. We compared 3-year graft survival with estimated outcomes based on KDPI. Additionally, the KDPI from grafts that failed were compared to group.

Results A total of 70 transplants were performed during this period. As listed in the table below, 3-year graft survival was better than expected with the associated KDPI’s ranging from 40-80%. Additionally, the mean KDPI for those patients that suffered graft loss was significantly higher than the patients without graft loss (73 ± 10 vs 66 ± 15, p =0.03).

Conclusions Graft survival from solitary pediatric donors is potentially better than estimated by respective KDPI. The risk for graft loss, however, increases with KDPI.

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