ArticleTransplantation direct2018
Procurement Biopsy Findings Versus Kidney Donor Risk Index for Predicting Renal Allograft Survival.
Article in Transplantation direct, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Time-Zero Kidney Biopsy and Deceased-Donor Transplant Outcomes: A Systematic Review and Meta-Analysis of Prognostic Value, Prediction, and Clinical Utility.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Assessing Deceased-Donor Kidneys Through Posttransplant Survival Prediction Algorithms.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Article
- An In-depth overview of artificial intelligence (AI) tool utilization across diverse phases of organ transplantation.Journal of translational medicine · 2025Review
- Association between Kidney Donor Risk Index, kidney graft function and histological changes in early post-transplant graft biopsy.Clinical kidney journal · 2023Article
- Artificial Intelligence Advances in Transplant Pathology.Bioengineering (Basel, Switzerland) · 2023Review
- Deceased-Donor Acute Kidney Injury and Acute Rejection in Kidney Transplant Recipients: A Multicenter Cohort.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2023Article
- Pretransplant kidney transcriptome captures intrinsic donor organ quality and predicts 24-month outcomes.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- The Independent Effects of Procurement Biopsy Findings on 10-Year Outcomes of Extended Criteria Donor Kidney Transplants.Kidney international reports · 2022Article
- Nonutilization of Kidneys From Donors After Circulatory Determinant of Death.Transplantation direct · 2022Article
- The Role of Procurement Biopsies in Kidney Acceptance Decision Making and Kidney Discard: Perceptions of Physicians, Nurse Coordinators, and OPO Staff and Directors.Transplantation direct · 2022Article
- A Review of Current and Emerging Trends in Donor Graft-Quality Assessment Techniques.Journal of clinical medicine · 2022Review
- Variations in deceased donor kidney procurement biopsy practice patterns: A survey of U.S. organ procurement organizations.Clinical transplantation · 2021Article
- Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes.Journal of clinical medicine · 2020Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundEfforts to maximize transplantation by matching organ quality to recipient longevity require reliable tools. The US kidney allocation system uses the Kidney Donor Risk Index (KDRI) for this purpose, and many centers additionally rely on donor biopsies. The Leuven score combines donor age with procurement histology (glomerulosclerosis and interstitial fibrosis/tubular atrophy) to predict allograft survival.
methodsWe compared KDRI with Leuven scores for associations with kidney discard, delayed graft function, and allograft function and survival. We used Cox, modified Poisson, and linear regression to calculate risks based on KDRI and (separately) Leuven scores, adjusting for important transplant and recipient variables.
resultsFrom 890 donors, 1729 kidneys were procured and biopsied. Five hundred eighty-five (34%) kidneys were discarded. Median donor age was 53 years (interquartile range [IQR], 44-61 years). Median KDRI and Leuven scores were 1.56 (IQR, 1.28-1.90) and 59 (IQR, 49-69). Relative risk for discard was 1.21 (95% confidence interval [CI], 1.17-1.24) per 0.2-unit increase in KDRI and 1.38 (1.31-1.46) per 10-unit increase in Leuven score. Adjusted relative risks for delayed graft function were 0.98 (95% CI, 0.94-1.02) and 0.94 (95% CI, 0.90-0.99), adjusted hazard ratios for graft failure were 1.10 (95% CI, 1.04-1.16) and 1.11 (95% CI, 1.02-1.21), and adjusted linear regression coefficients for 3-year estimated glomerular filtration rate were -3.88 (-4.63 to -3.13) and -5.18 (-6.19 to -4.18).
conclusionsIn kidneys clinically selected for procurement biopsy, the Leuven score was more strongly associated with discard but performed similarly to KDRI for predicting transplant outcomes, suggesting the need to reevaluate current procurement biopsy practices. Given modest associations for both tools; however, neither KDRI nor the Leuven score should be used in isolation for individual organ acceptance decisions.
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Registered trials
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