*Purpose: The study purpose was to review our kidney transplant (KT) experience with emphasis placed on outcomes in patients receiving kidneys that were “discordant” within the KDPI, ECD AND SCD classification schemes.

*Methods: Single center retrospective review of deceased donor (DD) KT recipients stratified into 2 groups: SCD high KDPI and ECD lower KDPI KTs. All patients received depleting antibody induction with tacrolimus/MPA/ ± steroids.

*Results: From 2003-2018, 16.5% (n=238) of all DDKTs showed discordance between donor classification systems: 32 SCD high KDPI (mean KDPI 90%) and 206 ECD lower KDPI (mean KDPI 76%). Mean donor and recipient ages were 47 and 59 yrs (SCD high KDPI) and 59 and 61 yrs (ECD lower KDPI), respectively. The SCD high KDPI group had more DCD donors (53 vs 13%) and more DDs with diabetes (42 vs 11%, both p<0.01) compared to the ECD lower KDPI group. With a mean follow-up of 6 years, actual patient survival, graft survival, death-censored graft survival rates between SCD high KDPI and ECD lower KDPI groups were 84% vs 67% (p<0.05), 63 vs 53% (NS), 74 vs 70% (NS), respectively. Delayed graft function and primary non-function rates between SCD high DKPI and ECD lower KDPI groups were 47 vs 29% (p<0.05) and 6 vs 2.4% (NS), respectively. 1-year serum creatinine levels were comparable between groups (1.8±0.8 SCD high KDPI vs 1.9±1.5 ECD lower KDPI, NS).

*Conclusions: Although the KDPI is widely used for assessment of kidney offers, the SCD/ECD classification remains relevant because survival outcomes of SCD high KDPI kidneys appear slightly higher than ECD lower KDPI kidneys, despite increased rates of delayed graft function in the SCD high KDPI category.

« Back to 2020 American Transplant Congress