{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T06:25:07Z","timestamp":1774592707611,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Time\u2010zero biopsies can detect donor\u2010derived lesions at the time of kidney transplantation, but their utility in predicting long\u2010term outcomes is unclear under the updated Kidney Allocation System.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a single\u2010center retrospective cohort study of 272 consecutive post\u2010reperfusion time\u2010zero biopsies. We tested the hypothesis that abnormal time\u2010zero histology is a strong indicator of donor quality that increases the precision of the kidney donor profile index (KDPI) score to predict long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We detected abnormal biopsies in 42% of the cohort, which were independently associated with a 1.2\u2010fold increased hazard for a composite of acute rejection, allograft failure, and death after adjusting for clinical characteristics including KDPI. By Kaplan\u2010Meier analysis, the relationship between abnormal time\u2010zero histology and the composite endpoint was only significant in the subgroup of deceased donor kidney transplants with KDPI scores &gt;35. Abnormal time\u2010zero histology, particularly vascular intimal fibrosis and arteriolar hyalinosis scores, was independently associated with lower 12\u2010month estimated GFR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, abnormal time\u2010zero histology is relatively common and identifies a group of kidney recipients at increased risk for worse long\u2010term outcomes. Further studies are needed to determine the optimal patient population in which to deploy time\u2010zero biopsies as an additional surveillance tool.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14676","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T08:23:55Z","timestamp":1650356635000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Abnormal time\u2010zero histology is predictive of kidney transplant outcomes"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3864-8198","authenticated-orcid":false,"given":"Syed Sikandar","family":"Raza","sequence":"first","affiliation":[{"name":"Department of Medicine University of Alabama School of Medicine  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurav","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Medicine University of 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