Darema Maria, Athanasopoulou Diamanto, Bellos Ioannis, Tsoumbou Ioanna, Vittoraki Angeliki G, Bokos John, Marinaki Smaragdi, Boletis Ioannis N
Department of Nephrology and Kidney Transplantation, Medical School, Laiko General Hospital of Athens, National and Kapodistrian University, 11527 Athens, Greece.
Immunology Department & National Tissue Typing Center, General Hospital of Athens "G. Gennimatas", 11527 Athens, Greece.
J Clin Med. 2023 Mar 22;12(6):2439. doi: 10.3390/jcm12062439.
The Kidney Donor Risk Index (KDRI) and Kidney Donor Profile Index (KDPI) have been developed to assess deceased-donor graft quality, although validation of their utility outside the USA remains limited. This single-center retrospective cohort study evaluated the ability of KDRI and KDPI to predict transplant outcomes in a Greek cohort. The efficacy of KDRI, KDPI, and donor's age in predicting death-censored graft failure was primarily assessed. Overall, 394 donors and 456 recipients were included. Death-censored graft survival was significantly worse with increasing KDRI (hazard ratio-HR: 2.21, 95% confidence intervals-CI: 1.16-4.22), KDPI (HR: 1.01, 95% CI: 1.00-1.02), and donor's age (HR: 1.03, 95% CI: 1.00-1.05). The unadjusted discriminative ability was similar for KDPI (C-statistic: 0.54) and donor's age (C-statistic: 0.52). The KDPI threshold of 85 was not predictive of graft failure (-value: 0.19). Higher KDPI was linked to delayed graft function and worse kidney function, but not among expanded-criteria donor transplantations. No significant association was found between KDRI, KDPI, and patient survival. In conclusion, increasing KDRI and KDPI are linked to worse graft function, although their ability to discriminate long-term graft failure remains limited.
肾脏供体风险指数（KDRI）和肾脏供体概况指数（KDPI）已被开发用于评估已故供体移植物的质量，不过其在美国以外地区效用的验证仍然有限。这项单中心回顾性队列研究评估了KDRI和KDPI预测希腊队列移植结局的能力。主要评估了KDRI、KDPI和供体年龄在预测死亡删失移植物失败方面的效能。总体而言，纳入了394名供体和456名受体。随着KDRI（风险比-HR：2.21，95%置信区间-CI：1.16-4.22）、KDPI（HR：1.01，95%CI：1.00-1.02）和供体年龄（HR：1.03，95%CI：1.00-1.05）的增加，死亡删失移植物存活率显著降低。KDPI（C统计量：0.54）和供体年龄（C统计量：0.52）的未校正鉴别能力相似。KDPI阈值为85并不能预测移植物失败（P值：0.19）。较高的KDPI与移植肾功能延迟和肾功能较差有关，但在扩大标准供体移植中并非如此。未发现KDRI、KDPI与患者生存率之间存在显著关联。总之，KDRI和KDPI的增加与移植物功能较差有关，尽管它们鉴别长期移植物失败的能力仍然有限。
