{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T19:40:48Z","timestamp":1784490048072,"version":"3.55.0"},"reference-count":46,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,3,1]],"date-time":"2015-03-01T00:00:00Z","timestamp":1425168000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Prog Transpl"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> The Kidney Transplant Morbidity Index (KTMI) is a novel prognostic morbidity index to help determine the impact that pretransplant comorbid conditions have on transplant outcome. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p> To use national data to validate the KTMI. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p> Retrospective analysis of the Organ Procurement and Transplant Network\/United Network for Organ Sharing database. <\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and Participants<\/jats:title><jats:p> The study sample consisted of 100 261 adult patients who received a kidney transplant between 2000 and 2008. <\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure<\/jats:title><jats:p> Kaplan-Meier survival curves were used to demonstrate 3-year graft and patient survival for each KTMI score. Cox proportional hazards regression models were created to determine hazards for 3-year graft failure and patient mortality for each KTMI score. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> A sequential decrease in graft survival (0 = 91.2%, 1 = 88.2%, 2 = 85.4%, 3 = 81.7%, 4 = 77.8%, 5 = 74.0%, 6 = 69.8%, and \u22657 = 68.7) and patient survival (0 = 98.2%, 1 = 96.6%, 2 = 93.7%, 3 = 89.7%, 4 = 84.8%, 5 = 80.8%, 6 = 76.0%, and \u22657 = 74.7%) is seen as KTMI scores increase. The differences in graft and patient survival between KTMI scores are all significant ( P &lt; .001) except between 6 and \u22657. Multivariate regression analysis reveals that KTMI is an independent predictor of higher graft failure and patient mortality rates and that risk increases as KTMI scores increase. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> The KTMI strongly predicts graft and patient survival by using pretransplant comorbid conditions; therefore, this easy-to-use tool can aid in determining outcome risk and transplant candidacy before listing, particularly in candidates with multiple comorbid conditions. <\/jats:p><\/jats:sec>","DOI":"10.7182\/pit2015462","type":"journal-article","created":{"date-parts":[[2015,3,11]],"date-time":"2015-03-11T01:13:22Z","timestamp":1426036402000},"page":"70-76","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["The Kidney Transplant Morbidity Index (KTMI): A Simple Prognostic Tool to Help Determine Outcome Risk in Kidney Transplant Candidates"],"prefix":"10.7182","volume":"25","author":[{"given":"Daniel","family":"Pieloch","sequence":"first","affiliation":[{"name":"Robert Wood Johnson University Hospital (DP, AJO, MD, RAM, SF, ZM, DAL) and Medical School (VD, AJO, MD, RAM, SF, ZM, DAL) New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"Dombrovskiy","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital (DP, AJO, MD, RAM, SF, ZM, DAL) and Medical School (VD, AJO, MD, RAM, SF, ZM, DAL) New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adena J.","family":"Osband","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital (DP, AJO, MD, RAM, SF, ZM, DAL) and Medical School (VD, AJO, MD, RAM, SF, ZM, DAL) New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meelie","family":"DebRoy","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital (DP, AJO, MD, RAM, SF, ZM, DAL) and Medical School (VD, AJO, MD, RAM, SF, ZM, DAL) New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Mann","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital (DP, AJO, MD, RAM, SF, ZM, DAL) and Medical School (VD, AJO, MD, RAM, SF, ZM, DAL) New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonalis","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital (DP, AJO, MD, RAM, SF, ZM, DAL) and Medical School (VD, AJO, MD, RAM, SF, ZM, DAL) New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahidul","family":"Mondal","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital (DP, AJO, MD, RAM, SF, ZM, DAL) and Medical School (VD, AJO, MD, RAM, SF, ZM, DAL) New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Laskow","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson University Hospital (DP, AJO, MD, RAM, SF, ZM, DAL) and Medical School (VD, AJO, MD, RAM, SF, ZM, DAL) New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,3,1]]},"reference":[{"key":"bibr1-pit2015462","volume-title":"Risk Adjustment for Measuring Health Care Outcomes.","author":"Lezzoni LE","year":"2003"},{"key":"bibr2-pit2015462","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000251780.01031.81"},{"key":"bibr3-pit2015462","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr524"},{"key":"bibr4-pit2015462","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(00)02452-0"},{"key":"bibr5-pit2015462","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200007270-00012"},{"key":"bibr6-pit2015462","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-13-79"},{"key":"bibr7-pit2015462","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00410.x"},{"key":"bibr8-pit2015462","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.02101.x"},{"key":"bibr9-pit2015462","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.06.134"},{"key":"bibr10-pit2015462","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2006.01.001"},{"key":"bibr11-pit2015462","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0012.2001.150302.x"},{"key":"bibr12-pit2015462","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2007.00695.x"},{"issue":"61","key":"bibr13-pit2015462","first-page":"15197","volume":"72","author":"Centers for Medicare &amp; 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