{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:42:56Z","timestamp":1777869776698,"version":"3.51.4"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neutrophil tubulointerstitial infiltration (NTI) of kidney grafts is commonly attributed to urinary tract infection (\u2018ascending nephritis\u2019). Without clinical evidence of urinary tract infection, it is an unexplained finding and was therefore explored in this retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>NTI after kidney transplantation was examined in 1753 recipients with 6749 biopsies, including protocol biopsies (59.1%) to determine the unbiased natural prevalence of NTI. We determined associated factors for NTI by logistic regression and graft outcomes with NTI by Kaplan\u2013Meier survival analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>NTI was diagnosed in 178 patients (10.2%), with 131 patients in the first transplant year and in 47 thereafter. Twenty-six patients (14.6%) had repeated findings of NTI, and 65 patients (36.5%) diffuse patterns of NTI. NTI was associated with inferior death-censored graft survival during long-term follow-up up to 21 years, especially with repeated and diffuse findings in the first transplant year. Common associated factors for NTI within and beyond the first year were urinary tract infections (22%) and female donor organs. Additionally, NTI during the first transplant year was associated with delayed graft function (1.5%), acute tubular injury (18.8%) and rejection (47.0%). After the first transplant year, female recipients, especially those of younger age, had NTI 2-fold more frequently, mainly coincident with urinary tract infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diagnosis of NTI should prompt the search for urinary tract infection and rejection. The association of NTI with rejection encourages further study on neutrophils in kidney graft rejection. The predisposition of female donor organs to NTI is a new observation and should be explored further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfaf219","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T11:53:39Z","timestamp":1761134019000},"page":"919-929","source":"Crossref","is-referenced-by-count":0,"title":["Neutrophil infiltration of kidney grafts: incidence, associated factors and graft survival"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0629-325X","authenticated-orcid":false,"given":"Julian","family":"Doricic","sequence":"first","affiliation":[{"name":"Hannover Medical School Department of Nephrology and Hypertension, , Hannover ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Greite","sequence":"additional","affiliation":[{"name":"Hannover Medical School Department of Nephrology and Hypertension, , Hannover ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan Hinrich","family":"Br\u00e4sen","sequence":"additional","affiliation":[{"name":"Nephropathology Unit, Institute of Pathology, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Schmidt-Ott","sequence":"additional","affiliation":[{"name":"Hannover Medical School Department of Nephrology and Hypertension, , Hannover ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Scheffner","sequence":"additional","affiliation":[{"name":"Hannover Medical School Department of Nephrology and Hypertension, , Hannover ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1703-893X","authenticated-orcid":false,"given":"Wilfried","family":"Gwinner","sequence":"additional","affiliation":[{"name":"Hannover Medical School Department of Nephrology and Hypertension, , Hannover ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"2026043010392044900_bib1","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"},{"key":"2026043010392044900_bib2","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1097\/00007890-200206270-00013","article-title":"The changing causes of graft loss and death after kidney transplantation","volume":"73","author":"Howard","year":"2002","journal-title":"Transplantation"},{"key":"2026043010392044900_bib3","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s40620-017-0379-9","article-title":"Infectious complications as the leading cause of death after kidney transplantation: analysis of more than 10,000 transplants from a single center","volume":"30","author":"de Castro Rodrigues Ferreira","year":"2017","journal-title":"J Nephrol"},{"key":"2026043010392044900_bib4","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1038\/ki.2010.219","article-title":"The impact of urinary tract infections in renal transplant recipients","volume":"78","author":"Lorenz","year":"2010","journal-title":"Kidney Int"},{"key":"2026043010392044900_bib5","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1053\/j.ajkd.2004.04.040","article-title":"Late urinary tract infection after renal transplantation in the United States","volume":"44","author":"Abbott","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"2026043010392044900_bib6","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1093\/ndt\/gfy131","article-title":"Risk factors for death in kidney transplant patients: analysis from a large protocol biopsy registry","volume":"34","author":"Abeling","year":"2019","journal-title":"Nephrol Dial Transplant"},{"key":"2026043010392044900_bib7","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1097\/TP.0000000000002922","article-title":"Patient survival after kidney transplantation: important role of graft-sustaining factors as determined by predictive modeling using random survival forest analysis","volume":"104","author":"Scheffner","year":"2020","journal-title":"Transplantation"},{"key":"2026043010392044900_bib8","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1111\/j.1600-6143.2006.01700.x","article-title":"Acute pyelonephritis represents a risk factor impairing long-term kidney graft function","volume":"7","author":"Pelle","year":"2007","journal-title":"Am J Transplant"},{"key":"2026043010392044900_bib9","first-page":"B965","article-title":"Asymptomatic acute transplant pyelonpehritis: a single-center experience","volume":"13","author":"Gregg","year":"2013","journal-title":"Am J Transplant"},{"key":"2026043010392044900_bib10","doi-asserted-by":"publisher","first-page":"e13801","DOI":"10.1111\/tid.13801","article-title":"Histologic acute graft pyelonephritis after kidney transplantation: incidence, clinical characteristics, risk factors, and association with graft loss","volume":"24","author":"Powers","year":"2022","journal-title":"Transpl Infect Dis"},{"key":"2026043010392044900_bib11","doi-asserted-by":"publisher","first-page":"161","DOI":"10.4103\/0971-4065.132009","article-title":"Renal outcome in biopsy proven cases of graft pyelonephritis","volume":"24","author":"Varma","year":"2014","journal-title":"Indian J Nephrol"},{"key":"2026043010392044900_bib12","article-title":"Infection-related tubulointerstitial nephritis","volume-title":"Heptinstall\u2019s Pathology of the Kidney","author":"Troxell","year":"2015","edition":"7th edn"},{"key":"2026043010392044900_bib13","doi-asserted-by":"publisher","first-page":"415","DOI":"10.4103\/1319-2442.284016","article-title":"Biopsy-proven acute graft pyelonephritis: a retrospective study from sindh institute of urology and transplantation","volume":"31","author":"Idrees","year":"2020","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"2026043010392044900_bib14","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1007\/s13167-023-00320-w","article-title":"Identification of potential necroinflammation-associated necroptosis-related biomarkers for delayed graft function and renal allograft failure: a machine learning-based exploration in the framework of predictive, preventive, and personalized medicine","volume":"14","author":"Bi","year":"2023","journal-title":"EPMA J"},{"key":"2026043010392044900_bib15","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1097\/TP.0b013e3182a04997","article-title":"Independent risk factors for urinary tract infection and for subsequent bacteremia or acute cellular rejection: a single-center report of 1166 kidney allograft recipients","volume":"96","author":"Lee","year":"2013","journal-title":"Transplantation"},{"key":"2026043010392044900_bib16","doi-asserted-by":"publisher","first-page":"e1433","DOI":"10.1097\/TXD.0000000000001433","article-title":"Effects of delayed graft function on transplant outcomes: a meta-analysis","volume":"9","author":"Li","year":"2023","journal-title":"Transplant Direct"},{"key":"2026043010392044900_bib17","doi-asserted-by":"publisher","first-page":"912749","DOI":"10.3389\/fimmu.2022.912749","article-title":"Combining clinical parameters and acute tubular injury grading is superior in predicting the prognosis of deceased-donor kidney transplantation: a 7-year observational study","volume":"13","author":"Wang","year":"2022","journal-title":"Front Immunol"},{"key":"2026043010392044900_bib18","doi-asserted-by":"publisher","first-page":"1684","DOI":"10.1111\/j.1600-6143.2008.02293.x","article-title":"Acute tubular injury in protocol biopsies of renal grafts: prevalence, associated factors and effect on long-term function","volume":"8","author":"Gwinner","year":"2008","journal-title":"Am J Transplant"},{"key":"2026043010392044900_bib19","doi-asserted-by":"publisher","first-page":"F881","DOI":"10.1152\/ajprenal.00519.2016","article-title":"Renal ischemia-reperfusion injury causes hypertension and renal perfusion impairment in the CD1 mice which promotes progressive renal fibrosis","volume":"314","author":"Greite","year":"2018","journal-title":"Am J Physiol Renal Physiol"},{"key":"2026043010392044900_bib20","doi-asserted-by":"publisher","first-page":"3262","DOI":"10.1016\/j.transproceed.2013.05.012","article-title":"Acute tubular injury is an important component in type I acute antibody-mediated rejection","volume":"45","author":"Johnson","year":"2013","journal-title":"Transplant Proc"},{"key":"2026043010392044900_bib21","doi-asserted-by":"publisher","first-page":"17","DOI":"10.23876\/j.krcp.20.003","article-title":"Diagnosis of renal transplant rejection: Banff classification and beyond","volume":"39","author":"Jeong","year":"2020","journal-title":"Kidney Res Clin Pract"},{"key":"2026043010392044900_bib22","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":"2026043010392044900_bib23","doi-asserted-by":"publisher","first-page":"4359","DOI":"10.1038\/s41467-023-39859-7","article-title":"Transcriptional and spatial profiling of the kidney allograft unravels a central role for FcyRIII+ innate immune cells in rejection","volume":"14","author":"Lamarthee","year":"2023","journal-title":"Nat Commun"},{"key":"2026043010392044900_bib24","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1034\/j.1600-6143.2003.00072.x","article-title":"Antibody-mediated rejection criteria\u2014an addition to the Banff 97 classification of renal allograft rejection","volume":"3","author":"Racusen","year":"2003","journal-title":"Am J Transplant"},{"key":"2026043010392044900_bib25","doi-asserted-by":"publisher","first-page":"e148747","DOI":"10.1172\/jci.insight.148747","article-title":"Recipient myeloperoxidase-producing cells regulate antibody-mediated acute versus chronic kidney allograft rejection","volume":"6","author":"Miyairi","year":"2021","journal-title":"JCI Insight"},{"key":"2026043010392044900_bib26","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1038\/modpathol.3800033","article-title":"Acute rejection and graft survival in renal transplanted patients with viral diseases","volume":"17","author":"Aiello","year":"2004","journal-title":"Mod Pathol"},{"key":"2026043010392044900_bib27","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1111\/j.1432-2277.2009.01001.x","article-title":"Plasma cell infiltrates in polyomavirus nephropathy","volume":"23","author":"Kemeny","year":"2010","journal-title":"Transpl Int"},{"key":"2026043010392044900_bib28","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.1097\/TP.0000000000003163","article-title":"The implications of B-lineage cells in kidney allografts","volume":"104","author":"Filippone","year":"2020","journal-title":"Transplantation"},{"key":"2026043010392044900_bib29","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1097\/TP.0000000000002041","article-title":"Clinical and pathological features of plasma cell-rich acute rejection after kidney transplantation","volume":"102","author":"Hasegawa","year":"2018","journal-title":"Transplantation"},{"key":"2026043010392044900_bib30","doi-asserted-by":"publisher","first-page":"239","DOI":"10.6002\/ect.2012.0216","article-title":"Systematic kidney biopsies after acute allograft pyelonephritis","volume":"11","author":"Cartery","year":"2013","journal-title":"Exp Clin Transplant"},{"key":"2026043010392044900_bib31","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1186\/s12882-023-03338-4","article-title":"Prevalence and risk factors of urinary tract infection in kidney recipients: a meta-analysis study","volume":"24","author":"Hosseinpour","year":"2023","journal-title":"BMC Nephrol"},{"key":"2026043010392044900_bib32","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1016\/j.transproceed.2022.03.031","article-title":"Effects of bacterial urinary tract infection on clinical outcome and survival of kidney transplant patients","volume":"54","author":"Nascimento","year":"2022","journal-title":"Transplant Proc"},{"key":"2026043010392044900_bib33","doi-asserted-by":"publisher","first-page":"195","DOI":"10.12659\/AOT.883901","article-title":"Urinary tract infections in kidney transplant recipients: role of gender, urologic abnormalities, and antimicrobial prophylaxis","volume":"18","author":"Ariza-Heredia","year":"2013","journal-title":"Ann Transplant"},{"key":"2026043010392044900_bib34","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1097\/TP.0000000000002915","article-title":"Donor-recipient sex differences do not affect survival outcomes after kidney transplantation: a population cohort study","volume":"104","author":"Morgan","year":"2020","journal-title":"Transplantation"},{"key":"2026043010392044900_bib35","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.genm.2012.07.004","article-title":"Donor-recipient sex mismatch in kidney transplantation","volume":"9","author":"Tan","year":"2012","journal-title":"Gend Med"},{"key":"2026043010392044900_bib36","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1093\/ndt\/gfad181","article-title":"Influence of donor sex and age on graft outcome in kidney transplantation","volume":"39","author":"Melk","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"2026043010392044900_bib37","doi-asserted-by":"publisher","first-page":"2688","DOI":"10.1016\/j.transproceed.2021.09.004","article-title":"Influence of donor and recipient sex matching in simultaneous pancreas-kidney transplantation outcomes","volume":"53","author":"Sanchez Hidalgo","year":"2021","journal-title":"Transplant Proc"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfaf219\/64883900\/gfaf219.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/41\/5\/919\/64883900\/gfaf219.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/41\/5\/919\/64883900\/gfaf219.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:39:29Z","timestamp":1777559969000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/41\/5\/919\/8300372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":37,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,10,23]]},"published-print":{"date-parts":[[2026,4,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfaf219","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2025,10,23]]}}}