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Multicenter Study
. 2018 Oct 5;13(10):e0205011.
doi: 10.1371/journal.pone.0205011. eCollection 2018.

Clinical significance of the Kidney Donor Profile Index in deceased donors for prediction of post-transplant clinical outcomes: A multicenter cohort study

Jong Hoon Lee  1   2 , Woo Yeong Park  3   4 , Young Soo Kim  5 , Bum Soon Choi  2 , Cheol Whee Park  2 , Chul Woo Yang  1   2 , Yong-Soo Kim  1   2 , Kyubok Jin  3   4 , Seungyeup Han  3   4 , Byung Ha Chung  1   2
Affiliations
Multicenter Study

Clinical significance of the Kidney Donor Profile Index in deceased donors for prediction of post-transplant clinical outcomes: A multicenter cohort study

Jong Hoon Lee et al. PLoS One. .

Abstract

Background: We investigated whether the Kidney Donor Profile Index (KDPI) system is useful in predicting clinical outcomes in deceased donor kidney transplantation (DDKT).

Methods: Four hundred sixty-nine kidney transplant recipients (KTRs) receiving kidneys from 359 deceased donors were included in this study, which involved three transplant centers. KTRs were divided into high and low KDPI KTR groups based on the median KDPI score of 67%. We compared clinical outcomes between the high KDPI and low KDPI groups.

Results: There were no significant differences in the incidence of delayed graft function and acute rejection between high and low KDPI KTR groups. In comparison with histologic findings in allograft tissues obtained within three months from KT, the proportion of glomerulosclerosis was significantly higher in the high KDPI KTR group than in the low KDPI KTR group. With Kaplan-Meier analysis, the graft survival rate was significantly lower in the high KDPI KTR group than in the low KDPI KTR group (Log rank, P = 0.017), and multivariate analysis also demonstrated that a high KDPI score was a significant risk factor for death censored allograft failure (HR 2.62, 95% CI, 1.29-5.33, P = 0.008).

Conclusion: The KDPI scoring system is useful in predicting allograft outcomes in a Korean DDKT cohort.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Distribution and algorithm.
(A) Distribution of deceased donors by KDPI score. (B) Algorithm and distribution of kidney donors and recipients in this study. Patients were divided into high or low KDPI KTR groups based on the median value of KDPI of 67%. The incidence of acute rejection, delayed graft function, graft loss, and patient death was evaluated.
Fig 2
Fig 2. Analysis of short-term outcomes.
(A) Comparison of the incidence of DGF between high and low KDPI KTR groups. *P<0.05 (B) Comparison of the incidence of biopsy-proven acute rejection between high and low KDPI KTR groups. (C) Comparison of the change of allograft function within one year after KT between high and low KDPI KTR groups (all P of each point <0.05).
Fig 3
Fig 3. Relationship between KDPI score and glomerulosclerosis.
Comparison of KDPI score and degree of chronic tissue injury (mean glomerulosclerosis percentage) in the results of allograft biopsy performed within three months after KT (rho = 0.368, P<0.001).
Fig 4
Fig 4. Analysis of long-term outcome.
(A) Comparison of death-censored graft survival rates between high and low KDPI KTR groups (P<0.001, Log-rank test) (B) Comparison of patient survival rates between high and low KDPI KTR groups (P = 0.132, Log-rank test).
See this image and copyright information in PMC

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