http://optn.transplant.hrsa.gov/ContentDocuments/Guide_to_Calculating_Interpreting_KDPI.pdfA Guide to Calculating and Interpreting the Kidney Donor Profile Index (KDPI)
What is the KDPI?
The Kidney Donor Profile Index (KDPI) is a numerical measure that combines ten dimensions of
information about a donor, including clinical parameters and demographics, to express the quality of the
donor kidneys relative to other donors. The KDPI is derived by first calculating the Kidney Donor Risk
Index (KDRI) for a deceased donor.
A donor with a KDPI of 90%, for example, has a KDRI greater than 90% of donors in the chosen reference
population. In this way, the KDPI is simply a mapping of the KDRI from a relative risk scale a cumulative
percentage scale. The reference population of donors is all deceased donors in the U.S. from whom a
kidney was recovered for the purpose of transplantation during the prior calendar year. Lower KDPI
values are associated with increased donor quality; higher KDPI values are associated with lower donor
quality.
What is the KDRI?
The Kidney Donor Risk Index (KDRI) is an estimate of the relative risk of post-transplant kidney graft
failure (in an average, adult recipient) from a particular deceased donor compared to the median (50th
percentile) donor. (Note that the choice of the median donor as the "reference donor" differs from the
age 40, non-diabetic, etc., reference donor described in the original KDRI publication1
.) A donor with a
KDRI of 1.28, for example, confers an estimated risk of kidney graft failure that is 1.28 times that of an
“average” donor. Lower KDRI values are associated with increased donor quality; higher KDRI values
are associated with lower donor quality.
What are the benefits of the KDPI?
KDPI is an improvement over the Expanded Criteria Donor (ECD)/Standard Criteria Donor (SCD)
dichotomy, in several ways:
• KDPI explicitly incorporates 10 donor factors (instead of 4 in the ECD definition) and is a more
precise measure of donor quality
• KDPI is a continuous “score” instead of a binary (yes/no) indicator
• KDPI illuminates the fact that not all ECDs are alike (see Figure 1):
o Some ECD kidneys have reasonably good estimated quality
o Some SCD kidneys actually have lower estimated quality than some ECDs
...