*Purpose: To evaluate the performance of the Kidney Donor Profile Index (KDPI) in predicting outcomes for kidney transplant recipients (KTR) of standard criteria donors (SCD) in a population whose index was not previously validated.

*Methods: A retrospective single-center cohort enrolled 1,943 KTR who received a kidney of SCD between 2013 and 2017 and followed up to 2018. The primary outcome was composed of death, graft loss, and 1-year graft function < 30 mL/min/1.73m2, estimated by CKD-Epi (eGFR). Spearman’s rank correlation coefficient assessed the linear association between KDPI and eGFR. Multivariable analysis for the primary outcome was performed by logistic regression, and the C-statistic evaluated the discrimination of the risk prediction model.

*Results: Recipients were 48.5 years old, 59.6% female, and 44.8% white. Donors were 41.0 years old, 61.6% male, and 52.2% white. Among donors, the prevalence of hypertension and diabetes was 24.9% and 3.8%, respectively. The main causes of brain death were subarachnoid hemorrhage (47.3%) and traumatic brain injury (41.2%). The median of KDPI was 52% (32; 69), stratified as follows: 28.9% of KDPI_1-35, 18.6% of KDPI_36-50, 48.3% of KDPI_51-85, and 4.3% of KDPI_>85. The incidence of delayed graft function and acute rejection (AR) was 58.6% and 18%, respectively. One-year eGFR was 52.8 mL/min. An inverse correlation was observed between 1-year eGFR and KDPI: R= -0.36; CI95%= -0.40; -0.32; P<0.001. The frequency of primary outcome was 14.4%: 4.4% of graft loss, 2.9% of death, and 7.7% of 1-year eGFR<30. The primary outcome was associated with a longer time in dialysis before transplantation (OR for each month = 1.003; P=0.03), CMV-related events (OR=1.32; P=0.04), AR (OR=2.13; P<0.001), and the KDPI strata. Compared to KDPI_1-35, the OR was 1.62 (P=0.03), 2.27 (P<0.001) and 2.21 (P=0.01) for strata 36-50, 51-85 and >85, respectively. This modeling reached a C-statistic of 0.64 (0.61-0.68), P<0.001.

*Conclusions: Despite not being previously validated for Brazilian donors, the KDPI significantly correlated with 1-year graft function in kidney transplant recipients of standard criteria donors. Furthermore, although the predictive model had reached a moderate discriminative power, the KDPI was an independent predictor of primary outcome composed of death, graft loss, and eGFR < 30 within 1-year after transplantation.

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