{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T21:01:14Z","timestamp":1785445274243,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Abdominal arterial calcification (AAC) is a common comorbidity in patients with end\u2010stage kidney disease (ESKD) and a predictor of cardiovascular events post\u2010kidney transplant. However, prior studies lacked a standardized approach to evaluate AAC and its impact on post\u2010transplant outcomes. This study aimed to correlate AAC score values with post\u2010kidney transplant outcomes using a modified scoring system traditionally applied to coronary artery calcification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 14\u00a0339 adult patients listed for kidney transplant between 2002 and 2023 at three transplant centers. Among them, 3683 patients met the criteria of undergoing a kidney transplant and an abdominal computed tomography (CT) scan pre\u2010transplant. We modified the coronary calcium score software by adjusting intake data points to quantify calcification in the abdominal aorta, common iliac, external iliac, and internal iliac arteries. Outcomes focused on post\u2010transplant mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 3683 kidney transplant recipients, higher AAC scores were significantly associated with increased mortality. Each 1000\u2010unit increase in AAC score elevated hazard ratios (HRs) across arterial regions, including 1.116 for the aorta and 1.389 for the internal iliac (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Adjusted analyses confirmed AAC as an independent risk factor for mortality. Kaplan\u2013Meier curves demonstrated lower survival with increasing AAC quartiles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AAC, measured by a standardized score, is a significant mortality risk factor in kidney transplant recipients. Integrating AAC scores into pre\u2010transplant evaluations could enhance risk stratification and improve outcomes. Prospective studies are needed to validate these findings and explore interventions to reduce AAC and improve survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70387","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T15:43:22Z","timestamp":1762962202000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Abdominal Arterial Calcification Score\u2010Association With Patient Survival Post Kidney Transplant"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1721-2415","authenticated-orcid":false,"given":"Amro","family":"Idilbi","sequence":"first","affiliation":[{"name":"Department of Transplant Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roaa","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tareq","family":"Hanouneh","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alia","family":"Alhassoun","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tala","family":"Nasrini","sequence":"additional","affiliation":[{"name":"Ko\u00e7 University School of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Haddad","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Hussam","family":"Hallak","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Sella","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren F.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"Craver","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Division of Clinical Trials and Biostatistics  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Alasfar","sequence":"additional","affiliation":[{"name":"Transplant Center Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1392-0792","authenticated-orcid":false,"given":"Mark D.","family":"Stegall","sequence":"additional","affiliation":[{"name":"Transplant Center Mayo Clinic Minnesota  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3274-3277","authenticated-orcid":false,"given":"Carrie","family":"Schinstock","sequence":"additional","affiliation":[{"name":"Transplant Center Mayo Clinic Minnesota  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9973-0470","authenticated-orcid":false,"given":"Tambi","family":"Jarmi","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic Florida  Jacksonville Florida 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