Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 18;14(10):3540.
doi: 10.3390/jcm14103540.

Validation of Kidney Donor Profile Index and Estimated Post-Transplant Survival Scores in an Eastern European Transplantation Center-A Seven-Year Retrospective Observational Study

Florin Ioan Elec  1   2 , Tudor Moisoiu  1   2   3 , Matei Florin Negrut  4 , Robert Simon  1   5   6 , Alina Daciana Elec  1 , Adriana Milena Muntean  1 , Georgeta Horciag  1 , Ana Maria Sitaru  7 , Andreea Liana Rachisan  8 , Gabriel Oniscu  9 , Oana Antal  1   5
Affiliations

Validation of Kidney Donor Profile Index and Estimated Post-Transplant Survival Scores in an Eastern European Transplantation Center-A Seven-Year Retrospective Observational Study

Florin Ioan Elec et al. J Clin Med. .

Abstract

Background/Objectives: The Kidney Donor Profile Index (KDPI) is an important metric for evaluating the quality of donor kidneys and predicting post-transplant outcomes. The Estimated Post-Transplant Survival (EPTS) score is a tool for estimating kidney transplant candidates' long-term survival. However, their validity in Eastern European cohorts is yet to be explored. This study aimed to evaluate the predictive accuracy of the KDPI and EPTS in a local cohort. Methods: We conducted a seven-year retrospective observational study at a high-volume transplant center in Romania. Data from 353 patients who received kidney transplants from brain-dead donors (DBDs) between 2017 and 2023 were analyzed. The KDPI scores were stratified into <35%, 35-85%, and >85%, while EPTS was stratified into <20%, 20-60%, and >60%. Primary outcomes included one-, three-, and five-year post-transplant graft function as estimated by eGFR, while secondary outcomes involved patient and graft survival rates at one, three, and five years. Results: Graft function and survival rates were significantly lower with increasing KDPI and EPTS scores, reinforcing the utility of both scores in clinical decision-making. Conclusions: Despite their limitations, KDPI and EPTS remain valuable predictors in our patient population.

Keywords: Estimated Post Transplant Survival (EPTS); Kidney Donor Profile Index (KDPI); organ allocation; predicting scoring system; transplant outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
A flow chart of the patients included in the study.
Figure 2
Figure 2
Frequency distributions for KDPI and EPTS scores.
Figure 3
Figure 3
EPTS score in the three KDPI groups.
Figure 4
Figure 4
eGFR at one (A), three (B), and five years (C) in the three KDPI groups.
Figure 5
Figure 5
Graft (A) and patient (B) survival in the three KDPI groups.
Figure 6
Figure 6
Graft (A) and patient (B) survival rates according to the EPTS score.
See this image and copyright information in PMC

References

    1. Wolfe R.A., Ashby V.B., Milford E.L., Ojo A.O., Ettenger R.E., Agodoa L.Y., Held P.J., Port F.K. Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant. N. Engl. J. Med. 1999;341:1725–1730. doi: 10.1056/NEJM199912023412303. - DOI - PubMed
    1. Coemans M., Süsal C., Döhler B., Anglicheau D., Giral M., Bestard O., Legendre C., Emonds M.-P., Kuypers D., Molenberghs G., et al. Analyses of the Short- and Long-Term Graft Survival after Kidney Transplantation in Europe between 1986 and 2015. Kidney Int. 2018;94:964–973. doi: 10.1016/j.kint.2018.05.018. - DOI - PubMed
    1. Summers D.M., Johnson R.J., Allen J., Fuggle S.V., Collett D., Watson C.J., Bradley J.A. Analysis of Factors That Affect Outcome after Transplantation of Kidneys Donated after Cardiac Death in the UK: A Cohort Study. Lancet. 2010;376:1303–1311. doi: 10.1016/S0140-6736(10)60827-6. - DOI - PubMed
    1. Stallone G., Grandaliano G. To Discard or Not to Discard: Transplantation and the Art of Scoring. Clin. Kidney J. 2019;12:564–568. doi: 10.1093/ckj/sfz032. - DOI - PMC - PubMed
    1. Chertow G.M., Milford E.L., Mackenzie H.S., Brenner B.M. Antigen-Independent Determinants of Cadaveric Kidney Transplant Failure. JAMA. 1996;276:1732–1736. doi: 10.1001/jama.1996.03540210040031. - DOI - PubMed

LinkOut - more resources