Abstract: FR-PO0999
Equitable Donor Assessment Model (EDAM): A Data-Driven Framework for Stratifying Deceased-Donor Kidney Quality
Session Information
- Transplantation: Clinical - Pretransplantation, Living Donation, and Policies
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Ali, Hatem, University Hospital of Wales, Cardiff, Wales, United Kingdom
- Daoud, Ahmed, Medical University of South Carolina, Charleston, South Carolina, United States
- Mohamed, Mahmoud Magdy, Southwest Nephrology Associates SC, Evergreen Park, Illinois, United States
- Molnar, Miklos Zsolt, University of Utah Health, Salt Lake City, Utah, United States
- Abd Elhafeez, Samar, Alexandria University, Alexandria, Alexandria Governorate, Egypt
- Cheungpasitporn, Wisit, Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
- Fulop, Tibor, Medical University of South Carolina, Charleston, South Carolina, United States
Background
This study introduces the Equitable Donor Assessment Model (EDAM), a risk stratification framework evaluating deceased donor kidney quality based solely on donor-derived factors, excluding ethnicity, to align with UNOS policy revisions.
Methods
Our methodology aims to develop and validate EDAM—a risk stratification framework that isolates donor-specific factors using Fine–Gray competing-risks regression—to provide a more precise and equitable assessment of deceased donor kidney quality for improved organ allocation. Using UNOS data (2010–2020) with follow-up through 2025, we analysed 121,261 deceased-donor kidney transplants . Risk stratification was achieved using Fine–Gray competing-risks regression, categorizing donors into four risk groups.
Results
Using Fine Gray competing risks regression, we developed the EDAM that includes donor-specific factors (age, cause of death, BMI, CMV serology, history of hypertension and diabetes, creatinine level, proteinuria, and sex) to predict graft failure. The model achieved a Harrell’s C-index of 0.69 (95% CI 0.63–0.75) and effectively stratified donors into distinct risk groups. Notably, the cumulative incidence of graft failure at both 5 and 10 years increased significantly with rising EDAM scores, P value equals 0.01.
Conclusion
EDAM provides a standardized, equitable framework for donor kidney assessment, enhancing fairness and precision in allocation, in line with UNOS policies.