What this means
Kidneys from donors with higher KDPI scores were more likely to fail over time in this review. The score alone does not predict well which kidney will fail.
Plain-English summary written by an AI model from the abstract. The original is below.
- Who it was tested in
- 5 studies with 2902 kidney recipients; 13 publications reviewed
- Kind of research
- A summary of earlier studies
The science
- Original title
- Kidney donor profile index (KDPI) score and long-term deceased donor kidney transplant outcomes: A systematic review and meta-analysis of cohort studies.
- Authors
- Raza A, AlDuaij A, Almutairi M et al.
- Journal
- Transplantation reviews (Orlando, Fla.)
- Published
- Oct 14, 2026
- Study type
- Review
- PMID
- 42874429 ↗
Abstract
The Kidney Donor Profile Index (KDPI) summarizes the expected longevity of deceased-donor kidneys, but its relationship with long-term graft outcomes and its performance outside the United States remain uncertain. We systematically reviewed cohort evidence evaluating KDPI and long-term deceased-donor kidney transplant outcomes. MEDLINE, Embase, Scopus, Web of Science, CENTRAL, and ClinicalTrials.gov were searched from January 2014 through June 2026. Eligible studies included at least 100 adult deceased-donor kidney recipients with outcomes assessed at a minimum three-year horizon. Adjusted hazard ratios (HRs) for death-censored graft failure were standardized to a 10-point KDPI increase and pooled using a random-effects model with restricted maximum likelihood and modified Hartung-Knapp intervals. Thirteen publications were included; five studies comprising 2902 recipients contributed comparable adjusted estimates. Each 10-point increase in KDPI was associated with a higher rate of death-censored graft failure (HR 1.19, 95% CI 1.08-1.31; I2 = 43.8%; 95% prediction interval 0.97-1.46). Restriction to three studies with explicit long-term follow-up yielded HR 1.14 (95% CI 1.02-1.27; I2 = 14.2%). The exploratory KDPI >85% analysis was imprecise (HR 2.13, 95% CI 0.75-6.02). Reported KDPI discrimination was generally limited, with C-statistics around 0.54-0.62. Higher KDPI is associated with worse long-term death-censored graft outcomes, but effect magnitude varies across settings and KDPI alone has limited discriminatory ability. Local validation and periodic recalibration remain important.
Raza A, AlDuaij A, Almutairi M et al. Kidney donor profile index (KDPI) score and long-term deceased donor kidney transplant outcomes: A systematic review and meta-analysis of cohort studies. Transplantation reviews (Orlando, Fla.). 2026. doi:10.1016/j.trre.2026.101059. PMID: 42874429. https://pubmed.ncbi.nlm.nih.gov/42874429/