ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2025
Association between out-of-sequence allocation and deceased donor kidney nonuse across organ procurement organizations.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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.
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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
7 citing papers in PubMed.
- Expedited Kidney Offers Are Occurring Earlier During Allocation.Kidney medicine · 2026Article
- Is the Current Practice of Out-of-Sequence Kidney Allocation Justified? Assessing Outcomes, Utility, Efficiency, and Equity.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Expedited Transplant Allocation Using a Paired Kidney Cohort.JAMA network open · 2026Article
- Changes in Deceased Donor Kidney Recovery and Transplantation after Increased Regulatory Oversight of Allocation Out of Sequence.Journal of the American Society of Nephrology : JASN · 2026Article
- Cellular and Molecular Changes Induced by Various Preservation Temperatures and Methods of Preservation in Renal Grafts and Other Solid Organ Grafts.International journal of molecular sciences · 2026Review
- Out-of-Sequence Placement of Deceased Donor Kidneys Is Exacerbating Inequities in the United States.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Article
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Authors and funding
7 authors.
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Abstract
Out-of-sequence (OOS) kidney allocation has become increasingly prevalent since 2021. We examined the relationship between organ procurement organization (OPO) OOS allocation frequency and kidney nonuse rates. Among 57 OPOs between March 2021 and December 2023, we analyzed trends in OOS utilization and its association with kidney nonuse rates. There was significant variability in OOS use across OPOs, with some allocating over 20% of kidneys out-of-sequence over the entire period. An absolute increase of 1 SD (12.8%) of OOS allocation was modestly associated with a reduction in kidney nonuse rates (incidence risk ratio = 0.98; P = .04). Donor characteristics, particularly older age, donation after circulatory death, and high kidney donor profile index, were the strongest predictors of nonuse. While OOS allocation may mitigate logistical challenges, other strategies may be more effective at reducing the nonuse rate.
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