ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2014
The Kidney Donor Profile Index (KDPI) of marginal donors allocated by standardized pretransplant donor biopsy assessment: distribution and association with graft outcomes.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
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52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 130 citations in OpenAlex.
- Time-Zero Kidney Biopsy and Deceased-Donor Transplant Outcomes: A Systematic Review and Meta-Analysis of Prognostic Value, Prediction, and Clinical Utility.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Kidney transplantation with preformed diabetic nephropathy kidney: review of pathological changes and clinical outcomes.Frontiers in endocrinology · 2025Pooled it
- Outcomes of Dual Kidney Transplantation from Donors with High Pre-Implantation Biopsy Scores.American journal of nephrology · 2026Article
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- Label-free viability assessment ofBiomedical optics express · 2026Article
- Donor kidney pathology combined with clinical parameters helps expand the kidney donor pool: a large-scale retrospective cohort study.Renal failure · 2025Article
- Real-Time Viability Assessment of Ex Vivo Mouse Kidneys for Transplant Applications Using Dynamic Optical Coherence Tomography.bioRxiv : the preprint server for biology · 2025Article
- Evaluating non-utilization of deceased donor kidneys in Korea.Scientific reports · 2025Article
- Preoperative donor urinary UDP-Glc as an independent risk factor for delayed graft function.Frontiers in immunology · 2025Observational
- Kidney transplants from elderly donors: what we have learned 20 years after the Crystal City consensus criteria meeting.Journal of nephrology · 2024Review
- Evaluating Cost-Effectiveness in Using High-Kidney Donor Profile Index Organs.Transplantation proceedings · 2023Article
- Large Area Kidney Imaging for Pre-transplant Evaluation using Real-Time Robotic Optical Coherence Tomography.Research square · 2023Article
- The association of center volume with transplant outcomes in selected high-risk groups in kidney transplantation.BMC nephrology · 2023Article
- European Society for Organ Transplantation (ESOT)-TLJ 3.0 Consensus on Histopathological Analysis of Pre-Implantation Donor Kidney Biopsy: Redefining the Role in the Process of Graft Assessment.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Disparities in Deceased Donor Kidney Offer Acceptance: A Survey of Canadian Transplant Nephrologists, General Surgeons and Urologists.Canadian journal of kidney health and disease · 2023Article
- Abnormal time-zero histology is predictive of kidney transplant outcomes.Clinical transplantation · 2022Article
- Beyond Graft Survivl: A National Cohort Study Quantifying the Impact of Increasing Kidney Donor Profile Index on Recipient Outcomes 1 Year Post-transplantation.Transplantation direct · 2022Article
- The Kidney Donor Profile Index (KDPI) Correlates With Histopathologic Findings in Post-reperfusion Baseline Biopsies and Predicts Kidney Transplant Outcome.Frontiers in medicine · 2022Article
- Variations in deceased donor kidney procurement biopsy practice patterns: A survey of U.S. organ procurement organizations.Clinical transplantation · 2021Article
- Impaired renal function before kidney procurement has a deleterious impact on allograft survival in very old deceased kidney donors.Scientific reports · 2021Article
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Authors and funding
26 authors at 5 institutions in 3 countries.
Funding
Abstract
Pretransplant donor biopsy (PTDB)-based marginal donor allocation systems to single or dual renal transplantation could increase the use of organs with Kidney Donor Profile Index (KDPI) in the highest range (e.g. >80 or >90), whose discard rate approximates 50% in the United States. To test this hypothesis, we retrospectively calculated the KDPI and analyzed the outcomes of 442 marginal kidney transplants (340 single transplants: 278 with a PTDB Remuzzi score<4 [median KDPI: 87; interquartile range (IQR): 78-94] and 62 with a score=4 [median KDPI: 87; IQR: 76-93]; 102 dual transplants [median KDPI: 93; IQR: 86-96]) and 248 single standard transplant controls (median KDPI: 36; IQR: 18-51). PTDB-based allocation of marginal grafts led to a limited discard rate of 15% for kidneys with KDPI of 80-90 and of 37% for kidneys with a KDPI of 91-100. Although 1-year estimated GFRs were significantly lower in recipients of marginal kidneys (-9.3, -17.9 and -18.8 mL/min, for dual transplants, single kidneys with PTDB score<4 and =4, respectively; p<0.001), graft survival (median follow-up 3.3 years) was similar between marginal and standard kidney transplants (hazard ratio: 1.20 [95% confidence interval: 0.80-1.79; p=0.38]). In conclusion, PTDB-based allocation allows the safe transplantation of kidneys with KDPI in the highest range that may otherwise be discarded.
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