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. 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.

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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.
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