{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:26:33Z","timestamp":1792009593526,"version":"4.4.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016298","name":"ERA-EDTA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016298","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We investigated 10-year trends in deceased donor kidney quality expressed as the kidney donor risk index (KDRI) and subsequent effects on survival outcomes in a European transplant population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Time trends in the crude and standardized KDRI between 2005 and 2015 by recipient age, sex, diabetic status and country were examined in 24\u2009177 adult kidney transplant recipients in seven European countries. We determined 5-year patient and graft survival probabilities and the risk of death and graft loss by transplant cohort (Cohort 1: 2005\u201306, Cohort 2: 2007\u201308, Cohort 3: 2009\u201310) and KDRI quintile.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median crude KDRI increased by 1.3% annually, from 1.31 [interquartile range (IQR) 1.08\u20131.63] in 2005 to 1.47 (IQR 1.16\u20131.90) in 2015. This increase, i.e. lower kidney quality, was driven predominantly by increases in donor age, hypertension and donation after circulatory death. With time, the gap between the median standardized KDRI in the youngest (18\u201344\u2009years) and oldest (&amp;gt;65\u2009years) recipients widened. There was no difference in the median standardized KDRI by recipient sex. The median standardized KDRI was highest in Austria, the Netherlands and the Basque Country (Spain). Within each transplant cohort, the 5-year patient and graft survival probability were higher for the lowest KDRIs. There was no difference in the patient and graft survival outcomes across transplant cohorts, however, over time the survival probabilities for the highest KDRIs improved.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The overall quality of deceased donor kidneys transplanted between 2005 and 2015 has decreased and varies between age groups and countries. Overall patient and graft outcomes remain unchanged.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfab156","type":"journal-article","created":{"date-parts":[[2021,4,10]],"date-time":"2021-04-10T11:42:47Z","timestamp":1618054967000},"page":"175-186","source":"Crossref","is-referenced-by-count":23,"title":["Temporal trends in the quality of deceased donor kidneys and kidney transplant outcomes in Europe: an analysis by the ERA-EDTA Registry"],"prefix":"10.1093","volume":"37","author":[{"given":"Maria","family":"Pippias","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK"},{"name":"Renal Unit, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vianda S","family":"Stel","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, ERA-EDTA Registry, Amsterdam Public Health Research Institute, UMC-Location AMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miha","family":"Arnol","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Centre for Kidney Transplantation, University Medical Centre Ljubljana, Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederike","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Department of Nephrology, UMC-Location AMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan P","family":"Berger","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadranka Buturovic","family":"Buturovic Ponikvar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"},{"name":"Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Kramar","sequence":"additional","affiliation":[{"name":"Austrian Dialysis and Transplant Registry, Rohr im Kremstal, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela","family":"Magaz","sequence":"additional","affiliation":[{"name":"Unidad de Informaci\u00f3n Sobre Pacientes Renales de la Comunidad Aut\u00f3noma del Pa\u00eds Vasco (UNIPAR), Basque, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Nordio","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Treviso General Hospital AULSS2, Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hessel","family":"Peters-Sengers","sequence":"additional","affiliation":[{"name":"Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Varberg","family":"Reis\u00e6ter","sequence":"additional","affiliation":[{"name":"Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren S","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziad A","family":"Massy","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Ambroise Pare University Hospital, AP-HP, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines (UVSQ), Boulogne, France"},{"name":"Institut National de la Sante et de la Recherche Medicale (INSERM) U1018, Team 5, CESP UVSQ, University Paris Saclay, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty J","family":"Jager","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, ERA-EDTA Registry, Amsterdam Public Health Research Institute, UMC-Location AMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"2021123116115740800_gfab156-B1","author":"Eurotransplant","year":"2015"},{"key":"2021123116115740800_gfab156-B2","author":"NHS Blood and Transplant"},{"key":"2021123116115740800_gfab156-B3","doi-asserted-by":"crossref","first-page":"e112","DOI":"10.1097\/TXD.0000000000000624","article-title":"Temporal changes in deceased kidney donor characteristics in Australia","volume":"2","author":"Chan","year":"2016","journal-title":"Transplant Direct"},{"issue":"Suppl 1","key":"2021123116115740800_gfab156-B4","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/01.TP.0000438215.16737.68","article-title":"Organ donation and transplantation in the UK\u2014the last decade: a report from the UK national transplant 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