Six-month monitoring shows expected progress after KDPI policy change

Published on: Thursday, December 11, 2025

A six-month monitoring report indicates that the removal of donor race and hepatitis C virus (HCV) status from the Kidney Donor Risk Index (KDRI) and the Kidney Donor Profile Index (KDPI) calculations is producing the anticipated effects on scores for donors who are Black and/or who test positive for HCV.

The KDPI score is used in allocation of kidneys from deceased donors, informed by the KDRI calculation. The policy change, implemented in October 2024, removed race and HCV variables from the calculation to better reflect the likely length of graft function from Black and/or HCV-positive donors.

Comparing data for six months before and after implementation, the median KDPI for non-Hispanic Black donors decreased from 69 percent to 58 percent (note: a lower KDPI percentage means the predicted length of post-transplant kidney function is longer). While the majority of donors remained in the same general KDPI range, the greatest areas of change were an increase in non-Hispanic Black donors in the zero to 20 percent KDPI category (longest estimated kidney function) and a decrease in non-Hispanic Black donors in the 86 to 100 percent group (shortest estimated kidney function). While these results are very preliminary, thus far they are consistent with expected policy outcomes.

At six months post-implementation, the median KDPI score for HCV-positive donors decreased from 68 percent to 57 percent, while the median for HCV-negative donors increased from 56 percent to 63 percent. This shift was also expected as a policy outcome.

The OPTN Minority Affairs Committee, which sponsored the policy, will continue to monitor its effects, with the next scheduled report to review one year of data.