©　2018　Chinese　Medical　Journal　|　Produced　by　Wolters　Kluwer　-　Medknow.　Background:　Hypothermic　machine　perfusion　(HMP)　is　being　used　more　often　in　cardiac　death　kidney　transplantation;　however,　the　significance　of　assessing　organ　quality　and　predicting　delayed　graft　function　(DGF)　by　HMP　parameters　is　still　controversial.　Therefore,　we　used　a　readily　available　HMP　variable　to　design　a　scoring　model　that　can　identify　the　highest　risk　of　DGF　and　provide　the　guidance　and　advice　for　organ　allocation　and　DCD　kidney　assessment.　Methods:　From　September　1,　2012　to　August　31,　2016,　366　qualified　kidneys　were　randomly　assigned　to　the　development　and　validation　cohorts　in　a　2:1　distribution.　The　HMP　variables　of　the　development　cohort　served　as　candidate　univariate　predictors　for　DGF.　The　independent　predictors　of　DGF　were　identified　by　multivariate　logistic　regression　analysis　with　a　P　＜　0.05.　According　to　the　odds　ratios　(ORs)　value,　each　HMP　variable　was　assigned　a　weighted　integer,　and　the　sum　of　the　integers　indicated　the　total　risk　score　for　each　kidney.　The　validation　cohort　was　used　to　verify　the　accuracy　and　reliability　of　the　scoring　model.　Results:　HMP　duration　(OR　=　1.165,　95%　confidence　interval　[CI]:　1.008-1.360,　P　=　0.043),　resistance　(OR　=　2.190,　95%　CI:　1.032-10.20,　P　＜　0.001),　and　flow　rate　(OR　=　0.931,　95%　CI:　0.894-0.967,　P　=　0.011)　were　the　independent　predictors　of　identified　DGF.　The　HMP　predictive　score　ranged　from　0　to　14,　and　there　was　a　clear　increase　in　the　incidence　of　DGF,　from　the　low　predictive　score　group　to　the　very　high　predictive　score　group.　We　formed　four　increasingly　serious　risk　categories　(scores　0-3,　4-7,　8-11,　and　12-14)　according　to　the　frequency　associated　with　the　different　risk　scores　of　DGF.　The　HMP　predictive　score　indicates　good　discriminative　power　with　a　c-statistic　of　0.706　in　the　validation　cohort,　and　it　had　significantly　better　prediction　value　for　DGF　compared　to　both　terminal　flow　(P　=　0.012)　and　resistance　(P　=　0.006).　Conclusion:　The　HMP　predictive　score　is　a　good　noninvasive　tool　for　assessing　the　quality　of　DCD　kidneys,　and　it　is　potentially　useful　for　physicians　in　making　optimal　decisions　about　the　organs　donated.