{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:13:14Z","timestamp":1790107994021,"version":"4.0.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite organ shortages, the discard rate of deceased donor kidneys is high. Risk factors for this trend warrant further study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We investigated reasons for discard in a cohort of brain death donors with marginal kidneys and procurement biopsies. Paraffin embedded procurement biopsies were systematically reevaluated and graded for the purpose of the study. Assessment included percentage of global glomerulosclerosis, Banff Lesion scores and tubular epithelial damage. Donor-, transplant process-, perfusion quality-, histopathology-, and recipient-related parameters were compared between discarded and transplanted organs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Although most clinical characteristics were similar between donors whose kidneys were transplanted and those whose kidneys were procured but discarded, discarded kidneys were more likely to be from donors with hepatitis C, to have undergone wedge biopsies, to show changes of acute and chronic injury and to be deemed poor quality. Except for obvious anatomic abnormalities, kidneys were often discarded due to the findings of procurement biopsies. Donors of kidneys discarded for histologic reasons more often had hypertension, coronary artery disease, stroke, and increased serum creatinine. The reason for discard was unknown in 20% of cases. Discarded kidneys came from donors who appeared to be clinically similar to donors whose kidneys were utilized for transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A considerable proportion of discarded kidneys were of acceptable quality. The analysis of the\u00a0outcome of every recovered organ could help to overcome this problem. Procurement biopsies more often lead to discard than to transplantation of recovered organs. Proper handling during allocation has to be determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-023-01785-8","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T03:02:54Z","timestamp":1697684574000},"page":"2587-2600","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Histological and clinical evaluation of discarded kidneys in a European cohort of deceased brain death donor kidneys of marginal quality"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6197-4720","authenticated-orcid":false,"given":"Florian G.","family":"Scurt","sequence":"first","affiliation":[{"name":"University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Otto-von Guericke University, Magdeburg, Germany 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0867-7668","authenticated-orcid":false,"given":"Carl-Ludwig","family":"Fischer-Fr\u00f6hlich","sequence":"additional","affiliation":[{"name":"Deutsche Stiftung Organtransplantation (Region Baden-W\u00fcrttemberg), Stuttgart, Germany 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8822-6992","authenticated-orcid":false,"given":"Tamara","family":"Wassermann","sequence":"additional","affiliation":[{"name":"Otto-von Guericke University, Magdeburg, Germany 3"},{"name":"Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg Str. 1, 30655, Hannover, Germany 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-1889","authenticated-orcid":false,"given":"Angela","family":"Ernst","sequence":"additional","affiliation":[{"name":"Institute of Medical Statistics and Bioinformatics, University of Cologne, Cologne, Germany 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg Str. 1, 30655, Hannover, Germany 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2929-8085","authenticated-orcid":false,"given":"Jan U.","family":"Becker","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital of Cologne, Cologne, Germany 6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6723-2346","authenticated-orcid":false,"given":"Christos","family":"Chatzikyrkou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg Str. 1, 30655, Hannover, Germany 4"},{"name":"Institute of Medical Statistics and Bioinformatics, University of Cologne, Cologne, Germany 5"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"key":"2026012110235300300_CR1","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.1600-6143.2007.02014.x","article-title":"Prospective age-matching in elderly kidney transplant recipients\u2014a 5-year analysis of the Eurotransplant Senior Program","volume":"8","author":"Frei","year":"2008","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR2","doi-asserted-by":"publisher","first-page":"2726","DOI":"10.1001\/jama.294.21.2726","article-title":"Deceased-donor characteristics and the survival benefit of kidney transplantation","volume":"294","author":"Merion","year":"2005","journal-title":"JAMA"},{"key":"2026012110235300300_CR3","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1056\/NEJM199912023412303","article-title":"Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant","volume":"341","author":"Wolfe","year":"1999","journal-title":"N Engl J Med"},{"issue":"Suppl 2","key":"2026012110235300300_CR4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1111\/ajt.16982","article-title":"OPTN\/SRTR 2020 annual data report: kidney","volume":"22","author":"Lentine","year":"2022","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR5","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/j.transproceed.2019.01.015","article-title":"Predictors of outcomes of living kidney donation: impact of sex, age and preexistent hypertension","volume":"51","author":"Chatzikyrkou","year":"2019","journal-title":"Transplant Proc"},{"key":"2026012110235300300_CR6","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1053\/j.ajkd.2019.11.005","article-title":"Cost-effectiveness of using kidneys from HCV-viremic donors for transplantation into HCV-uninfected recipients","volume":"75","author":"Eckman","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"2026012110235300300_CR7","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1111\/tri.13712","article-title":"Kidney exchange strategies: new aspects and applications with a focus on deceased donor-initiated chains","volume":"33","author":"Furian","year":"2020","journal-title":"Transpl Int"},{"key":"2026012110235300300_CR8","doi-asserted-by":"publisher","first-page":"2059","DOI":"10.1016\/S0140-6736(18)32091-9","article-title":"Clinical outcomes after ABO-incompatible renal transplantation: a systematic review and meta-analysis","volume":"393","author":"Scurt","year":"2019","journal-title":"Lancet"},{"key":"2026012110235300300_CR9","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1056\/NEJMoa1508380","article-title":"Survival benefit with kidney transplants from HLA-incompatible live donors","volume":"374","author":"Orandi","year":"2016","journal-title":"N Engl J Med"},{"key":"2026012110235300300_CR10","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1016\/S0140-6736(19)32592-9","article-title":"Clinical outcomes after ABO-incompatible renal transplantation\u2014authors\u2019 reply","volume":"394","author":"Scurt","year":"2019","journal-title":"Lancet"},{"key":"2026012110235300300_CR11","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1097\/TP.0000000000001539","article-title":"Diagnosing the decades-long rise in the deceased donor kidney discard rate in the United States","volume":"101","author":"Stewart","year":"2017","journal-title":"Transplantation"},{"key":"2026012110235300300_CR12","doi-asserted-by":"publisher","first-page":"3413","DOI":"10.1111\/ajt.15952","article-title":"Kidney nonprocurement in solid organ donors in the United States","volume":"20","author":"Yu","year":"2020","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR13","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.kint.2018.02.016","article-title":"Factors leading to the discard of deceased donor kidneys in the United States","volume":"94","author":"Mohan","year":"2018","journal-title":"Kidney Int"},{"key":"2026012110235300300_CR14","doi-asserted-by":"publisher","first-page":"11410","DOI":"10.3389\/ti.2023.11410","article-title":"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","volume":"36","author":"Zaza","year":"2023","journal-title":"Transpl Int"},{"key":"2026012110235300300_CR15","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s40620-019-00638-7","article-title":"Pre-implantation kidney biopsy: value of the expertise in determining histological score and comparison with the whole organ on a series of discarded kidneys","volume":"33","author":"Girolami","year":"2020","journal-title":"J Nephrol"},{"key":"2026012110235300300_CR16","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.1016\/j.ekir.2019.06.011","article-title":"A systematic review of interpathologist agreement in histologic classification of lupus nephritis","volume":"4","author":"Dasari","year":"2019","journal-title":"Kidney Int Rep"},{"key":"2026012110235300300_CR17","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.2215\/CJN.02270409","article-title":"The alphabet soup of kidney transplantation: SCD, DCD, ECD\u2013fundamentals for the practicing nephrologist","volume":"4","author":"Rao","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026012110235300300_CR18","doi-asserted-by":"publisher","first-page":"R204","DOI":"10.1186\/cc2872","article-title":"Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group","volume":"8","author":"Bellomo","year":"2004","journal-title":"Crit Care"},{"key":"2026012110235300300_CR19","doi-asserted-by":"publisher","first-page":"1632","DOI":"10.1111\/ajt.13162","article-title":"Early graft loss after kidney transplantation: risk factors and consequences","volume":"15","author":"Hamed","year":"2015","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR20","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.1111\/j.1600-6143.2011.03754.x","article-title":"Delayed graft function in the kidney transplant","volume":"11","author":"Siedlecki","year":"2011","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR21","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.1111\/ajt.13717","article-title":"Survival analysis in the presence of competing risks: the example of waitlisted kidney transplant candidates","volume":"16","author":"Sapir-Pichhadze","year":"2016","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR22","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1111\/j.1600-6143.2011.03926.x","article-title":"Banff 2011 Meeting report: new concepts in antibody-mediated rejection","volume":"12","author":"Mengel","year":"2012","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR23","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1111\/ajt.13929","article-title":"Banff histopathological consensus criteria for preimplantation kidney biopsies","volume":"17","author":"Liapis","year":"2017","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR24","doi-asserted-by":"publisher","first-page":"1934","DOI":"10.1111\/j.1600-6143.2005.00938.x","article-title":"Early calcification of renal allografts detected by protocol biopsies: causes and clinical implications","volume":"5","author":"Gwinner","year":"2005","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR25","doi-asserted-by":"publisher","first-page":"F701","DOI":"10.1152\/ajprenal.00189.2017","article-title":"Distinct morphological features of acute tubular injury in renal allografts correlate with clinical outcome","volume":"315","author":"Schumann-Bischoff","year":"2018","journal-title":"Am J Physiol Renal Physiol"},{"key":"2026012110235300300_CR26","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.14000","article-title":"Histological characteristics of acute tubular injury during delayed graft function predict renal function after renal transplantation","volume":"7","author":"Pieters","year":"2019","journal-title":"Physiol Rep"},{"key":"2026012110235300300_CR27","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1097\/01.tp.0000282868.86529.31","article-title":"Donor biopsy and kidney transplant outcomes: an analysis using the Organ Procurement and Transplantation Network\/United Network for Organ Sharing (OPTN\/UNOS) database","volume":"84","author":"Bajwa","year":"2007","journal-title":"Transplantation"},{"key":"2026012110235300300_CR28","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1111\/j.1600-6143.2008.02157.x","article-title":"Determinants of discard of expanded criteria donor kidneys: impact of biopsy and machine perfusion","volume":"8","author":"Sung","year":"2008","journal-title":"Am J Transplant"},{"key":"2026012110235300300_CR29","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.3390\/jcm9051469","article-title":"Degree of glomerulosclerosis in procurement kidney biopsies from marginal donor kidneys and their implications in predicting graft outcomes","volume":"9","author":"Cheungpasitporn","year":"2020","journal-title":"J Clin Med"},{"key":"2026012110235300300_CR30","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1111\/ctr.12539","article-title":"Donor kidney microthrombi and outcomes of kidney transplant: a single-center experience","volume":"29","author":"Sood","year":"2015","journal-title":"Clin Transplant"},{"key":"2026012110235300300_CR31","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1053\/j.ajkd.2020.08.015","article-title":"Histopathologic correlates of kidney function: insights from nephrectomy specimens","volume":"77","author":"Li","year":"2021","journal-title":"Am J Kidney Dis"},{"key":"2026012110235300300_CR32","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.kint.2020.02.027","article-title":"Artificial intelligence and machine learning in nephropathology","volume":"98","author":"Becker","year":"2020","journal-title":"Kidney Int"}],"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-023-01785-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40620-023-01785-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/joneph\/article-pdf\/36\/9\/2587\/66512536\/joneph_36_9_1785.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-023-01785-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/academic.oup.com\/joneph\/article-pdf\/36\/9\/2587\/66512536\/joneph_36_9_1785.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T15:23:57Z","timestamp":1769009037000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/article\/36\/9\/2587\/8303645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,19]]},"references-count":32,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,10,19]]},"published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1007\/s40620-023-01785-8","relation":{},"ISSN":["1121-8428","1724-6059"],"issn-type":[{"value":"1121-8428","type":"print"},{"value":"1724-6059","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,12,1]]},"published":{"date-parts":[[2023,10,19]]},"assertion":[{"value":"4 September 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflicts of interests to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}