ArticleKidney international reports2022
The Independent Effects of Procurement Biopsy Findings on 10-Year Outcomes of Extended Criteria Donor Kidney Transplants.
Article in Kidney international reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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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.
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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
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 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
- Preimplantation Histopathologic Assessment of Deceased Donor Kidneys: Recommendations from the Banff Time-Zero Biopsy Working Group.Journal of the American Society of Nephrology : JASN · 2025Guideline
- Evaluation of kidney procurement biopsy and machine perfusion on allograft outcomes: A retrospective cohort study of the Organ Procurement and Transplantation Network database.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- The early impacts of an attempt to standardize kidney procurement biopsy practices.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Galileo-an Artificial Intelligence tool for evaluating pre-implantation kidney biopsies.Journal of nephrology · 2025Article
- Impact of differentially expressed genes and proteins in donor arterial plaque on renal function recovery following allogeneic kidney transplantation.Translational andrology and urology · 2025Article
- Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy.Renal failure · 2024Article
- Decoding the hallmarks of allograft dysfunction with a comprehensive pan-organ transcriptomic atlas.Nature medicine · 2024Article
- Kidney transplants from elderly donors: what we have learned 20 years after the Crystal City consensus criteria meeting.Journal of nephrology · 2024Review
- Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome.Transplant international : official journal of the European Society for Organ Transplantation · 2024Article
- Deceased donor kidneys from higher distressed communities are significantly less likely to be utilized for transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2023Article
- OPTN/SRTR 2021 Annual Data Report: Kidney.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2023Article
- The Independent Effects of Kidney Length and Vascular Plaque on Ten-Year Outcomes of Extended Criteria Donor Kidney Transplants.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- European Society for Organ Transplantation (ESOT)-TLJ 3.0 Consensus on Histopathological Analysis of Pre-Implantation Donor Kidney Biopsy: Redefining the Role in the Process of Graft Assessment.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: The role of procurement biopsies in deceased donor kidney evaluation is debated in light of uncertainty about the influence of biopsy findings on recipient outcomes. The literature is filled with conflicting and ambiguous findings typically derived from small studies focused on short-term outcomes or reliant on biopsies prepared by methods impractical in the time-sensitive context of organ procurement. Methods: After manual data entry of DonorNet attachments from 4480 extended criteria donors (ECDs) recovered in the United States from 2008 to 2012, we applied causal inference methods in a Cox regression framework to estimate independent effects of glomerulosclerosis (GS), interstitial fibrosis, and vascular changes on long-term kidney graft survival. Kidney discard rates from 2018 to 2019 were evaluated to characterize contemporary kidney utilization patterns. Results: Effects of interstitial fibrosis and vascular changes were largely attenuated after adjusting for potentially confounding donor and recipient variables, although conclusions are less certain for severe levels due to smaller sample sizes. By contrast, significant effects of GS (>10% vs. 0%-5%) persisted even after adjustment (all-cause, hazard ratio [HR] 1.18; 95% CI 1.06, 1.28; death-censored, HR 1.28; 95% CI 1.08, 1.46) but plateaued beyond 10%. By contrast, kidney discard rates increased precipitously as GS rose >10%. Conclusion: Despite being obtained under less than ideal conditions, estimated GS from a procurement biopsy is independently associated with long-term graft survival, above and beyond standard clinical parameters, in ECD transplants. However, the disproportionately high likelihood of discard for kidneys with GS >10% is unjustified. The outsized effect of GS on kidney utilization should be tempered and commensurate with its effect on outcomes.
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