First Asian Kidney Donor Profile Index (KDPI) and Estimated Post-Transplant Survival (EPTS) models, with validation against US models in Thai population

Abstract

Introduction: Differences in transplant characteristics limit the application of kidney donor profile index (KDPI) and estimated post-transplant survival (EPTS) models developed in Western countries to Asian populations. Methods: We analyzed data of the Thai Transplant Registry and the Thai Red Cross Society on 2558 DDKTs performed between 2001 and 2014. Thai KDPI and EPTS models were developed using Cox regression, and validation against the US models. Results: Thai KDPI was developed based on seven donor factors: age, height, best estimated glomerular filtration rate, diabetes mellitus, hypertension, cerebrovascular accident, and adrenaline infusion. The Thai and US donor risk index had comparable predictive abilities for transplant survival (C-statistics.5871 vs.5548; P =.429). KTs from donors with a US KDPI > 70% demonstrated significantly worse 5-year transplant survival. The Thai EPTS model was developed from four recipient factors: age, body weight, diabetes mellitus, and hepatitis C infection. The C-statistics of the Thai and US EPTS models were comparable (.5924 vs.6039; P =.360). A US EPTS > 70% was revealed in only 2.5% of our cohort. Conclusions: The first simplified KDPI and EPTS models for an Asian population were developed. Our models are available at www.thai-kdpi-epts.org.