Korean J Transplant.  2022 Nov;36(Supple 1):S140. 10.4285/ATW2022.F-2608.

Clinical relevance of the Living Kidney Donor Profile Index in Asian kidney transplant recipients

• Kim HJ

• KMID: 2535656
• DOI: http://doi.org/10.4285/ATW2022.F-2608

Abstract

Background
The Living Kidney Donor Profile Index (LKDPI) was developed in the United States to predict the graft outcomes. There are significant differences in donor demographics, access to transplantation, proportion of ABO-incompatibility, and posttransplant mortality in Asian countries as compared with the United States. We evaluate the clinical relevance of LKDPI score in Asian kidney transplant recipients.
Methods
We analyzed 1,877 patients who underwent kidney transplantation between 2000 and 2019. Patients were divided into three groups according to the LKDPI score: <0, 1–19.9, and 20.
Results
The median LKDPI score was 3.11 (interquartile range, –8.9 to 16.7); 42.9% of donors had LKDPI <0, and 2.3% of do-nors had LKDPI >50. In total, mean age of the 1,877 donors was 41.0 years and 12.0% recipients received ABO-incompatible graft. During a median follow-up of 119 months, 87 (4.6%) patients died and 238 (12.7%) patients experienced death-censored graft loss. The 10-year death-censored graft survival rates were 92.2%, 88.6%, and 86.0% for LKDPI score of <0, 1–19.9 and 20 groups (P<0.001). LKDPI group was significantly associated with an increased risk of death-censored graft loss, independent of recipient characteristics (LKDPI, 1–19.9; hazard ratio, 1.389; 95% CI, 1.036–1.863 and LKDPI, 20; hazard ratio, 2.121; 95% CI, 1.50–2.998). By contrast, overall patient survival rates were comparable among LKDPI groups. LKDPI was also significantly as-sociated with posttransplant graft renal function.
Conclusions
Among the Asian kidney transplant recipients, high LKDPI score is associated with an increased risk of death-censored graft loss and poor graft renal function.