ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2016
Changes in Discard Rate After the Introduction of the Kidney Donor Profile Index (KDPI).
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers.
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Who cites it
66 citing papers in PubMed.
- The impact of kidney donor profile index on delayed graft function and transplant outcomes: A single-center analysis.Clinical transplantation · 2018Trial
- Outcomes of Dual Kidney Transplantation from Donors with High Pre-Implantation Biopsy Scores.American journal of nephrology · 2026Article
- Quantitative Assessment of Kidney Interstitial Fibrosis Using Optical Spectroscopy Mediated through a Fine Needle Probe.Kidney360 · 2026Article
- Responsible Use of Artificial Intelligence to Improve Kidney Care: A Statement from the American Society of Nephrology.Journal of the American Society of Nephrology : JASN · 2026Review
- Equitable Donor Assessment Model of Deceased Donor Kidney Quality.Kidney international reports · 2026Article
- Eligibility, timing, and organ quality: indications and outcomes of kidney transplantation in older patients.Kidney international · 2026Review
- "Rethinking High-KDPI Kidneys: A Multidomain Approach to Predicting Success".Clinical transplantation · 2026Article
- Label-free viability assessment ofBiomedical optics express · 2026Article
- Predictive Models for Kidney Offer Acceptance: Challenges and Strategies.Journal of transplantation · 2026Article
- Review
- Donor kidney pathology combined with clinical parameters helps expand the kidney donor pool: a large-scale retrospective cohort study.Renal failure · 2025Article
- Predictive value of aortoiliac calcification of deceased donors for chronicity score of allograft baseline biopsies and graft outcomes in kidney transplantation: a retrospective cohort study.Annals of surgical treatment and research · 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
- First-Person Authorization and Family Objections to Organ Donation.The Journal of medicine and philosophy · 2025Article
- Fixing a Mismatch: The Case for Age-Aligned Kidney Allocation.Transplant international : official journal of the European Society for Organ Transplantation · 2025Article
- When impact trials are not feasible: alternatives to study the impact of prediction models on clinical practice.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Present and Future Applications of Artificial Intelligence in Kidney Transplantation.Journal of clinical medicine · 2024Review
- Multicenter, prospective, observational study for urinary exosomal biomarkers of kidney allograft fibrosis.Scientific reports · 2024Observational
- A Transplant-Inclusive Value-Based Kidney Care Payment Model.Kidney international reports · 2024Review
- Expanding Access to High KDPI Kidney Transplant for Recipients Aged 60 y and Older: Cost Utility and Survival.Transplantation direct · 2024Article
6 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors.
Funding
Abstract
Since March 26, 2012, the Kidney Donor Profile Index (KDPI) has been provided with all deceased-donor kidney offers, with the goal of improving the expanded criteria donor (ECD) indicator. Although an improved risk index may facilitate identification and transplantation of marginal yet viable kidneys, a granular percentile system may reduce provider-patient communication flexibility, paradoxically leading to more discards ("labeling effect"). We studied the discard rates of the kidneys recovered for transplantation between March 26, 2010 and March 25, 2012 ("ECD era," N = 28 636) and March 26, 2012 and March 25, 2014 ("KDPI era," N = 29 021) using Scientific Registry of Transplant Recipients (SRTR) data. There was no significant change in discard rate from ECD era (18.1%) to KDPI era (18.3%) among the entire population (adjusted odds ratio [aOR] = 0.97 1.041.10 , p = 0.3), or in any KDPI stratum. However, among kidneys in which ECD and KDPI indicators were discordant, "high risk" standard criteria donor (SCD) kidneys (with KDPI > 85) were at increased risk of discard in the KDPI era (aOR = 1.07 1.421.89 , p = 0.02). Yet, recipients of these kidneys were at much lower risk of death (adjusted Risk Ratio [aRR] = 0.56 0.770.94 at 2 years posttransplant) compared to those remaining on dialysis waiting for low-KDPI kidneys. Our findings suggest that there might be an unexpected, harmful labeling effect of reporting a high KDPI for SCD kidneys, without the expected advantage of providing a more granular risk index.
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