Miller Jonathan M, Poff Kelley, Howell Jesse N, Serrano Oscar K, Kim Jim, Diez Alejandro, Lyden Grace R, Thompson Bryn W, Zaun David, Snyder Jon J
Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.
Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, Virginia, USA.
Am J Transplant. 2025 Jun;25(6):1245-1252. doi: 10.1016/j.ajt.2025.01.015. Epub 2025 Jan 19.
This study reports the results of a recalculation of the kidney donor risk index (KDRI) formula requested by the Organ Procurement and Transplantation Network's Minority Affairs Committee to remove the donor race and hepatitis C virus (HCV) status variables. The updated KDRI model was fit on adult, deceased donor, solitary kidney, first-time transplants from 2018-2021. Deceased donors from 2018 through 2021 were included in a counterfactual analysis to evaluate how the kidney donor profile index (KDPI) would change if race and HCV seropositivity were excluded. When recalculating the original KDRI models on 2018-2021 transplants, the donor Black race coefficient was only slightly lower (β = 0.18 in the original model; β = 0.15 in the 2018-2021 cohort), while the donor HCV seropositivity coefficient was substantially lower (β = 0.24 in the original model; β = -0.04 in the 2018-2021 cohort). Among Black donors, the probability of being classified as KDPI ≤20% increased and the probability of being classified as KDPI >85% decreased notably when the Black race and HCV variables were removed from the model. Removing the donor race and donor HCV status variables in an updated KDRI model resulted in more racially equitable KDPI distributions.
本研究报告了器官获取与移植网络少数族裔事务委员会要求重新计算肾脏供体风险指数（KDRI）公式的结果，以去除供体种族和丙型肝炎病毒（HCV）状态变量。更新后的KDRI模型适用于2018 - 2021年的成年、已故供体、单肾、首次移植。2018年至2021年的已故供体被纳入反事实分析，以评估如果排除种族和HCV血清学阳性，肾脏供体概况指数（KDPI）将如何变化。在对2018 - 2021年移植的原始KDRI模型进行重新计算时，供体黑人种族系数仅略低（原始模型中β = 0.18；2018 - 2021年队列中β = 0.15），而供体HCV血清学阳性系数则大幅降低（原始模型中β = 0.24；2018 - 2021年队列中β = -0.04）。在黑人供体中，当从模型中去除黑人种族和HCV变量时，被归类为KDPI≤20%的概率增加，被归类为KDPI>85%的概率显著降低。在更新的KDRI模型中去除供体种族和供体HCV状态变量导致了更具种族公平性的KDPI分布。
