Evidence map›Paper›PMID 41954271›Full record

ArticleClinical transplantation2026

Outcomes of Kidney Transplants From Donors With Stage 3 Acute Kidney Injury Requiring Dialysis: A National Cohort Study.

Amber B Paulus, Gaurav Gupta, Ahmet Gungor, Alice Toll, Alexandra Lewis, Carlos Martinez, Cassandra McCharen, Wida Cherikh, Bekir Tanriover

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PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Amber B PaulusDivision of Nephrology, Department of Internal Medicine, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Gaurav GuptaDivision of Nephrology, Department of Internal Medicine, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Ahmet GungorDivision of Nephrology, Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
Alice TollUnited Network of Organ Sharing (UNOS), Richmond, Virginia, USA.
Alexandra LewisUnited Network of Organ Sharing (UNOS), Richmond, Virginia, USA.
Carlos MartinezUnited Network of Organ Sharing (UNOS), Richmond, Virginia, USA.
Cassandra McCharenUnited Network of Organ Sharing (UNOS), Richmond, Virginia, USA.
Wida CherikhUnited Network of Organ Sharing (UNOS), Richmond, Virginia, USA.
Bekir TanrioverDivision of Nephrology, Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.

Funding

VCU division of nephrology
6 · The paper itself

Abstract

backgroundWhether severe donor acute kidney injury (AKI) requiring dialysis affects posttransplant outcomes remains debated and may influence center-level acceptance decisions.

methodsThis retrospective cohort study of United States deceased-donor kidney transplants (2015-2020) used OPTN data with follow-up through September 2024. Donor AKI was staged by KDIGO 2012 criteria, and dialysis was identified using a validated rule-based natural language processing (NLP) algorithm applied to DonorNet records. The primary outcome was all-cause graft failure (ACGF). Secondary outcomes included delayed graft function (DGF), 1-year estimated glomerular filtration rate (eGFR), and a composite tolerability outcome within 6 months defined as DGF, eGFR <30 mL/min/1.73 m

resultsOf 74 939 transplants, 24.6% were from AKI donors (Stage 2 7.8%, Stage 3 without dialysis 5.8%, Stage 3 with dialysis 2.1%). DGF increased with AKI severity (Stage 3 with dialysis 54.5% vs Stage 2 38.1%), but adjusted ACGF risk was similar across groups. Donor KDPI and recipient EPTS were stronger predictors of graft failure than AKI stage. Exploratory tolerability analyses showed that early adverse outcomes were driven primarily by recipient age, BMI, dialysis duration, and organ quality, not by donor AKI severity or dialysis.

conclusionsAmong transplanted kidneys, Stage 3 AKI requiring donor dialysis was associated with higher early DGF but similar adjusted graft survival compared with Stage 2 AKI after accounting for organ quality and recipient risk. These findings reflect outcomes among AKI-affected kidneys accepted for transplantation and should not be generalized to declined or discarded kidneys.

Indexed as

Acute Kidney InjuryDelayed Graft FunctionGraft RejectionKidney Failure, ChronicKidney TransplantationPostoperative ComplicationsRenal DialysisTissue DonorsAdultFemaleFollow-Up StudiesGlomerular Filtration RateGraft SurvivalHumansMaleMiddle Agedacute kidney injurydeceased donordelayed graft functiongraft survivalinverse probability weightingkidney donor profile indexkidney transplantation

Identifiers

PMID41954271
PMCPMC13063797

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