ArticleTransplant international : official journal of the European Society for Organ Transplantation2019
Functional status-based risk-benefit analyses of high-KDPI kidney transplant versus dialysis.
Article in Transplant international : official journal of the European Society for Organ Transplantation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The trial behind it
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Who cites it
11 citing papers in PubMed, 29 citations in OpenAlex.
- Health Care Utilization in Elderly Deceased Donor Kidney Transplant Recipients: Does Kidney Donor Profile Index Matter?Kidney360 · 2026Article
- Quantifying Center-level Aggressiveness in Transplanting Suboptimal, Deceased Donor Kidneys in the United States.Transplantation direct · 2026Article
- Scoring donor lungs for graft failure risk: The Lung Donor Risk Index (LDRI).American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- Program Report: Expanding the Deceased Donor Pool in Manitoba With an Age-Targeted Kidney Transplant Program.Canadian journal of kidney health and disease · 2024Article
- Kidney organ allocation: reducing discards.Current opinion in organ transplantation · 2023Review
- Characteristics of Kidney Recipients of High Kidney Donor Profile Index Kidneys as Identified by Machine Learning Consensus Clustering.Journal of personalized medicine · 2022Article
- Patient and Clinician Perceptions of Informed Consent and Decision Making About Accepting KDPI > 85 Kidneys.Transplantation direct · 2022Article
- Use of expanded-criteria donors and > 85 KDPI kidneys for pediatric kidney transplantation in the United States.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Physician and patient acceptance of policies to reduce kidney discard.Clinical transplantation · 2020Article
- Impact of Functional Status on Outcomes of Simultaneous Pancreas-kidney Transplantation: Risks and Opportunities for Patient Benefit.Transplantation direct · 2020Article
- The Author's Reply: Improving Functional Status Reporting may Save Patient Lives and Reduce Kidney Discard.Transplantation · 2020Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
Yearly, over half of deceased-donor kidneys with kidney donor profile index (KDPI) > 85 were discarded, yet they could improve survival outcomes for dialysis patients. The potential risk of high-KDPI kidney transplant (KT) depends on the patient's overall health summarized by functional status, which should be examined. The analyzed cohort consisted of adult deceased-donor KT candidates on dialysis listed in 2005-2014. A multivariate Cox proportional hazards model was fitted with functional status, measured using Karnofsky Performance Score (KPS), and transplant status as time-varying covariates. Derived from the Cox model, survival curves were analyzed to compare the survival outcomes between dialysis and transplant with different kidney qualities across three different KPS strata: 10-40, 50-70, and 80-100. With KDPI 0-99 KT, KPS 10-40 patients will survive ≥4.38 years median compared with 3.21 years median if they remained on dialysis. For KPS 50+ patients, the median survival years increase from 5.82 to 6.60 years on dialysis to ≥7.83 years after KDPI < 100 KT. The risk-adjusted analyses suggested that patients are expected to benefit more from KDPI 81-99 KT than from remaining on dialysis.
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Registered trials
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