Evidence map›Paper›PMID 42593848›Full record

ArticleClinical transplantation2026

Recipient Selection and Outcomes After Out-of-Sequence Kidney Allocation Since Implementation of Kidney Allocation System 250 (KAS250): A Single-Center Experience.

Sandesh Parajuli, Glen E Leverson, Didier Mandelbrot, Dixon B Kaufman

Abstract read
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.

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1citing papers in PubMed
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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

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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

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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

4 authors.

Sandesh ParajuliDivision of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Glen E LeversonDivision of Transplant Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Didier MandelbrotDivision of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Dixon B KaufmanDivision of Transplant Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAllocation out of sequence (AOOS) of kidneys has increased after KAS250 and raised concerns regarding transparency and equitable recipient selection. Less is known about recipient selection and outcomes at individual centers.

methodsWe performed a single-center retrospective study of adult deceased donor kidney transplants at the University of Wisconsin from March 15, 2021, to March 31, 2024. Recipients receiving kidneys classified as AOOS were compared with contemporaneous recipients of non-AOOS kidneys. Donor and recipient characteristics, delayed graft function, graft function, and patient and graft survival were assessed. Standardized data explaining why kidneys entered AOOS allocation were unavailable.

resultsAmong 498 deceased donor kidney transplant recipients, 89 (17.9%) received AOOS classified kidneys. Donor characteristics were largely similar, although kidneys categorized as AOOS had higher terminal creatinine (1.6 vs. 1.2 mg/dl, p = 0.03) and longer cold ischemia time (22.9 vs. 20.4 h, p = 0.003). AOOS recipients were older, more often preemptive, had shorter waiting times, and were less likely to be retransplant recipients or have cPRA > 20%. Recipient sex and race did not differ. Four-year adjusted patient survival (aHR 0.85; 95% CI 0.38-1.94; p = 0.71) and graft survival (aHR 0.72; 95% CI 0.34-1.54; p = 0.40) were not statistically different.

conclusionIn this single-center experience, transplantation of kidneys categorized as AOOS was associated with distinct recipient selection, comparable 4-year outcomes, and without compromising gender/racial balance.

Indexed as

Graft RejectionKidney Failure, ChronicKidney TransplantationPatient SelectionTissue and Organ ProcurementTissue DonorsTransplant RecipientsAdultFemaleFollow-Up StudiesGlomerular Filtration RateGraft SurvivalHumansKidney Function TestsMaleMiddle Agedgraft survivalKAS250kidney transplantationout‐of‐sequence allocationrecipient selection

Identifiers

PMID42593848
PMCPMC13472284

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