{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:59:44Z","timestamp":1780502384621,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T00:00:00Z","timestamp":1658188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High kidney\u2010donor profile index (KDPI) kidneys have a shorter survival than grafts with lower KDPI values. It is still unclear, however, whether their shorter longevity depends on an inferior baseline function, faster functional decline, or the combination of both.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed the estimated glomerular filtration rate (eGFR) of 605 consecutive recipients of deceased donor kidney transplants (KT) at 1, 3, 6, 12, 18, 24, 36, 48, and 60 months. Comparisons were performed among four groups based on KDPI quartile: Group I\u2010KDPI \u2264 25% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0151), Group II\u2010KDPI 26\u201350% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0182), Group III\u2010KDPI 51\u201375% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0176), and Group IV\u2010KDPI \u232a 75% (<jats:italic>n<\/jats:italic>\u00a0=\u00a096). Linear mixed model analysis was subsequently used to assess whether KDPI was independently associated with the decline in eGFR during the first 5\u2010years after KT. We also analyzed the incidence of delayed graft function (DGF), rejection within the first year after KT, patient survival, graft survival, and death censored graft survival based on KDPI group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>High\u2010KDPI grafts had lower eGFR immediately after KT, had a higher incidence of DGF and rejection. However, there were no signifcant differences in the adjusted rate (slope) of decline in eGFR among the four KDPI groups (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.06). Although patient survival was signigicantly lower for recipients of high\u2010KDPI grafts, death\u2010censored graft survival was similar among the four KDPI groups (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.33).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The shorter functional survival of high\u2010KDPI grafts seems to be due to their lower baseline eGFR rather than a more rapid functional decline after KT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14759","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T02:23:51Z","timestamp":1656728631000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Function and longevity of renal grafts from high\u2010KDPI donors"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9763-6253","authenticated-orcid":false,"given":"Michele","family":"Molinari","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Transplantation University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Kaltenmeier","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Transplantation University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eishan","family":"Ashwat","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Transplantation University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Jorgensen","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Transplantation University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Biostatistics, Division of Transplantation University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4856-9242","authenticated-orcid":false,"given":"Chethan","family":"Puttarajappa","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3770-8446","authenticated-orcid":false,"given":"Rajil","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0503-4707","authenticated-orcid":false,"given":"Puneet","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirav","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania 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