{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:22:46Z","timestamp":1791804166058,"version":"4.3.4"},"reference-count":26,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T00:00:00Z","timestamp":1679443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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\u2019s 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\u2014HR: 2.21, 95% confidence intervals\u2014CI: 1.16\u20134.22), KDPI (HR: 1.01, 95% CI: 1.00\u20131.02), and donor\u2019s age (HR: 1.03, 95% CI: 1.00\u20131.05). The unadjusted discriminative ability was similar for KDPI (C-statistic: 0.54) and donor\u2019s age (C-statistic: 0.52). The KDPI threshold of 85 was not predictive of graft failure (p-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.<\/jats:p>","DOI":"10.3390\/jcm12062439","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T09:10:04Z","timestamp":1679476204000},"page":"2439","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of Kidney Donor Risk Index\/Kidney Donor Profile Index as Predictor Tools of Deceased-Donor Kidney Transplant Outcomes in a Greek Cohort"],"prefix":"10.3390","volume":"12","author":[{"given":"Maria","family":"Darema","sequence":"first","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Medical School, Laiko General Hospital of Athens, National and Kapodistrian University, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diamanto","family":"Athanasopoulou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Medical School, Laiko General Hospital of Athens, National and Kapodistrian University, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Bellos","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Medical School, Laiko General Hospital of Athens, National and Kapodistrian University, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Tsoumbou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Medical School, Laiko General Hospital of Athens, National and Kapodistrian University, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeliki G.","family":"Vittoraki","sequence":"additional","affiliation":[{"name":"Immunology Department & National Tissue Typing Center, General Hospital of Athens \u201cG. Gennimatas\u201d, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Bokos","sequence":"additional","affiliation":[{"name":"Transplantation Unit, Laiko General Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smaragdi","family":"Marinaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Medical School, Laiko General Hospital of Athens, National and Kapodistrian University, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis N.","family":"Boletis","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Medical School, Laiko General Hospital of Athens, National and Kapodistrian University, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1159\/000514550","article-title":"Global Epidemiology of End-Stage Kidney Disease and Disparities in Kidney Replacement Therapy","volume":"52","author":"Thurlow","year":"2021","journal-title":"Am. J. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1056\/NEJM199912023412303","article-title":"Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant","volume":"341","author":"Wolfe","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_3","first-page":"81","article-title":"The Global Role of Kidney Transplantation","volume":"6","author":"Harden","year":"2012","journal-title":"Iran. J. Kidney Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1097\/00007890-200211150-00014","article-title":"Donor Characteristics Associated with Reduced Graft Survival: An Approach to Expanding the Pool of Kidney Donors","volume":"74","author":"Port","year":"2002","journal-title":"Transplantation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1111\/tri.12736","article-title":"Comparison of Survival Outcomes between Expanded Criteria Donor and Standard Criteria Donor Kidney Transplant Recipients: A Systematic Review and Meta-Analysis","volume":"29","author":"Querard","year":"2016","journal-title":"Transpl. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/TP.0b013e3181ac620b","article-title":"A Comprehensive Risk Quantification Score for Deceased Donor Kidneys: The Kidney Donor Risk Index","volume":"88","author":"Rao","year":"2009","journal-title":"Transplantation"},{"key":"ref_7","unstructured":"US Department of Health and Human Services (2022, August 10). Organ Procurement and Transplantation Network: KDPI Calculator, Available online: https:\/\/optn.transplant.hrsa.gov\/data\/allocation-calculators\/kdpi-calculator\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2054358118761052","DOI":"10.1177\/2054358118761052","article-title":"An Examination of the Application of the Kidney Donor Risk Index in British Columbia","volume":"5","author":"Rose","year":"2018","journal-title":"Can. J. Kidney Health Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1034\/j.1600-6143.3.s4.11.x","article-title":"Expanded Criteria Donors for Kidney Transplantation","volume":"3","author":"Metzger","year":"2003","journal-title":"Am. J. Transplant."},{"key":"ref_10","unstructured":"Organ Procurement and Transplantation Network (2022, August 10). KDRI to KDPI Mapping Table 2020, Available online: https:\/\/optn.transplant.hrsa.gov\/media\/2150\/kdpi_mapping_table.pdf."},{"key":"ref_11","unstructured":"(2022, August 10). Organ Procurement and Transplantation Network Estimated Post Transplant Survival Calculator, Available online: https:\/\/optn.transplant.hrsa.gov\/resources\/allocation-calculators\/epts-calculator."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A New Equation to Estimate Glomerular Filtration Rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_13","unstructured":"Therneau, T. (2020). A Package for Survival Analysis in R, R Foundation for Statistical Computing."},{"key":"ref_14","unstructured":"Kassambara, A., Kosinski, M., and Biecek, P. (2021). Package \u201cSurvminer\u201d Type Package Title Drawing Survival Curves Using \u201cGgplot2\u201d, R Foundation for Statistical Computing."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1080\/01621459.1951.10500769","article-title":"The Kolmogorov-Smirnov Test for Goodness of Fit","volume":"46","author":"Massey","year":"1951","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1214\/09-SS051","article-title":"Wilcoxon-Mann-Whitney or T-Test? On Assumptions for Hypothesis Tests and Multiple Interpretations of Decision Rules","volume":"4","author":"Fay","year":"2010","journal-title":"Stat. Surv."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"152","DOI":"10.5395\/rde.2017.42.2.152","article-title":"Statistical Notes for Clinical Researchers: Chi-Squared Test and Fisher\u2019s Exact Test","volume":"42","author":"Kim","year":"2017","journal-title":"Restor. Dent. Endod."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/sim.4780030207","article-title":"Regression Modelling Strategies for Improved Prognostic Prediction","volume":"3","author":"Harrell","year":"1984","journal-title":"Stat. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1093\/ndt\/gfy030","article-title":"Assessment of the Kidney Donor Profile Index in a European Cohort","volume":"33","author":"Lehner","year":"2018","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"11234","DOI":"10.1038\/s41598-019-47772-7","article-title":"Validation of the Kidney Donor Profile Index (KDPI) to Assess a Deceased Donor\u2019s Kidneys\u2019 Outcome in a European Cohort","volume":"9","author":"Dahmen","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.nefroe.2018.03.012","article-title":"Usefulness of the KDPI in Spain: A Comparison with Donor Age and Definition of Standard\/Expanded Criteria Donor","volume":"38","author":"Buxeda","year":"2018","journal-title":"Nefrol. (Engl. Ed.)"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1093\/ckj\/sfy130","article-title":"Assessing the Discrimination of the Kidney Donor Risk Index\/Kidney Donor Profile Index Scores for Allograft Failure and Estimated Glomerular Filtration Rate in Ireland\u2019s National Kidney Transplant Programme","volume":"12","author":"Sexton","year":"2019","journal-title":"Clin. Kidney J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1016\/j.transproceed.2020.03.005","article-title":"Kidney Donor Risk Index Score Is More Reliable Than Kidney Donor Profile Index in Kidney Transplantation from Elderly Deceased Donors","volume":"52","author":"Jun","year":"2020","journal-title":"Transplant. Proc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.trre.2016.10.002","article-title":"A Critical Assessment on Kidney Allocation Systems","volume":"31","author":"Formica","year":"2017","journal-title":"Transplant. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1093\/ndt\/gfx257","article-title":"Does Kidney Donor Risk Index Implementation Lead to the Transplantation of More and Higher-Quality Donor Kidneys?","volume":"32","author":"Philipse","year":"2017","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/ndt\/gfab156","article-title":"Temporal Trends in the Quality of Deceased Donor Kidneys and Kidney Transplant Outcomes in Europe: An Analysis by the ERA-EDTA Registry","volume":"37","author":"Pippias","year":"2022","journal-title":"Nephrol. Dial. Transplant."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/6\/2439\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:00:49Z","timestamp":1760122849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/6\/2439"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,22]]},"references-count":26,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["jcm12062439"],"URL":"https:\/\/doi.org\/10.3390\/jcm12062439","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,22]]}}}