Race and hepatitis C status no longer included in calculation used to estimate deceased donor kidney function; policy change anticipated to increase equity

Published on: Thursday, October 31, 2024

On Oct. 31, 2024, the Organ Procurement and Transplantation Network (OPTN) implemented a new policy revising the Kidney Donor Profile Index (KDPI), a calculation that summarizes the quality of deceased donor kidneys according to several criteria. The revised KDPI now excludes two variables used in the previous calculation:

1. whether the potential donor is African American/Black
2. whether the potential donor has tested positive for the hepatitis C virus (HCV)

In addition to removing race and HCV, score components for the remaining deceased donor characteristics which make up the KDPI have been adjusted to compensate for the removal of those two variables. Read the policy notice and Board briefing paper for additional details.

This OPTN policy change intends to better estimate the probability of graft failure from all donors. Research has shown that race is a poor proxy for human genetic variation and innovations in treatment have made post-transplant outcomes for HCV positive deceased donor kidney transplants similar to that of HCV negative donor kidneys. This new calculation is anticipated to increase equity and transparency in the nation's procurement and transplantation system. The new policy may also potentially decrease non-use of deceased donor kidneys.

Background

This policy was sponsored by the OPTN Minority Affairs Committee. The policy was approved by the OPTN Board of Directors at its in-person meeting on June 17, 2024, following a two-month winter 2024 public comment period that was open Jan. 23 - March 19, 2024.

Learn more about the OPTN policy development process.