*Purpose: Recently, the number of deceased donor kidneys(DDK) has been limited, so living donor kidney transplantation((LDKT) accounts for nearly 40% of kidney transplants worldwide. This not only results in lack of deceased donor organs, but also contributes to better graft survival compared to DDK. According to recent reports, a risk index for LDKT such as the Kidney donor profile index (KDPI), a non-invasive method for assessing the kidneys of deceased donors prior to transplantation, has been studied. In this study, data were collected from donors and recipients registered in the Korean Organ Transplantation Registry (KOTRY) with retrospective medical records and prospective follow-up cohorts of patients undergoing KT. We analyze the LKDPI and confirm if LKDPI could be a tool for predicting graft survival in living donor transplant patients on the same scale as the KDPI.

*Methods: The study population was derived from the KOTRY database. All of the 3,952 kidney recipients who registered in the KOTRY database between April 2014 and December 2018 were enrolled. Donor information (donation date, age, sex, race, blood type, BMI, History, HLA typing, previous hemodialysis and kidney transplantation, lab finding, etc.), and recipients information (kidney transplant date, age, sex, race, BMI, blood type, HLA typing, the result of survival, renal funtion, lab finding, etc.) were observed. We then, mesured LKDPI with these factors and analyzed whether graft loss could be predicted by LKDPI score. In addition, we mesured KDPI by using DDKT donor data, and compared the differences between KDPI and LKDPI according to the range of values.

*Results: Among 3,952 kidney recipients, 2514 (63.6%) who received LDKT were calculated LKDPI by using their donor and recipient informations. Then, 2514 patients were divided into four groups according to the LKDPI score, and figured out the relationship between cumulative graft loss and LKDPI values. The median LKDPI was -16.05. We validated that the higher LKDPI score was, the higher the all graft loss risk and the death-censord graft loss risk. The same results were founded in multivariate analysis which corrected recipient factors affecting graft loss risk. In addition, we measured KDPI scores, known as predictive prognostic factors of DDKT, in 1438 DDKT patients (36.4%), and then, matched population analysis was performed by grouping the LKDPI values ​​of LDK patients into the same category. There was no difference in the cumulative graft loss between the two groups.

*Conclusions: In this study, we confirmed that LKDPI could be an independent predictor for assessing the risk of graft loss via donor and recipient information in kidney transplant patients in Korea. It may be useful and helpful for patients who are struggling between wating DDKT and going LDKT.

« Back to 2020 American Transplant Congress