# Validation of Kidney Donor Profile Index and Estimated Post-Transplant Survival Scores in an Eastern European Transplantation Center—A Seven-Year Retrospective Observational Study

## TL;DR

This study validates the usefulness of KDPI and EPTS scores in predicting kidney transplant outcomes in an Eastern European population.

## Contribution

The study confirms the applicability of KDPI and EPTS scores in an Eastern European transplant cohort.

## Key findings

- Higher KDPI and EPTS scores correlated with lower graft function and survival rates.
- KDPI and EPTS scores proved valuable for clinical decision-making in kidney transplants.
- Graft function and survival rates were significantly impacted by donor and recipient scores.

## Abstract

Background/Objectives: The Kidney Donor Profile Index (KDPI) is an important metric for evaluating the quality of donor kidneys and predicting post-transplant outcomes. The Estimated Post-Transplant Survival (EPTS) score is a tool for estimating kidney transplant candidates’ long-term survival. However, their validity in Eastern European cohorts is yet to be explored. This study aimed to evaluate the predictive accuracy of the KDPI and EPTS in a local cohort. Methods: We conducted a seven-year retrospective observational study at a high-volume transplant center in Romania. Data from 353 patients who received kidney transplants from brain-dead donors (DBDs) between 2017 and 2023 were analyzed. The KDPI scores were stratified into <35%, 35–85%, and >85%, while EPTS was stratified into <20%, 20–60%, and >60%. Primary outcomes included one-, three-, and five-year post-transplant graft function as estimated by eGFR, while secondary outcomes involved patient and graft survival rates at one, three, and five years. Results: Graft function and survival rates were significantly lower with increasing KDPI and EPTS scores, reinforcing the utility of both scores in clinical decision-making. Conclusions: Despite their limitations, KDPI and EPTS remain valuable predictors in our patient population.