{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T17:35:47Z","timestamp":1777224947727,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"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":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Whether severe donor acute kidney injury (AKI) requiring dialysis affects posttransplant outcomes remains debated and may influence center\u2010level acceptance decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study of United States deceased\u2010donor kidney transplants (2015\u20132020) used OPTN data with follow\u2010up through September 2024. Donor AKI was staged by KDIGO 2012 criteria, and dialysis was identified using a validated rule\u2010based natural language processing (NLP) algorithm applied to DonorNet records. The primary outcome was all\u2010cause graft failure (ACGF). Secondary outcomes included delayed graft function (DGF), 1\u2010year estimated glomerular filtration rate (eGFR), and a composite tolerability outcome within 6 months defined as DGF, eGFR &lt;30\u00a0mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      , graft failure, or death. Models used inverse probability weighting (IPW), clustering by transplant center, and exploratory interpretable machine learning.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 74\u00a0939 transplants, 24.6% were from AKI donors (Stage 2 7.8%, Stage 3 without dialysis 5.8%, Stage 3 with dialysis 2.1%). DGF increased with AKI severity (Stage 3 with dialysis 54.5%\u00a0vs Stage 2 38.1%), but adjusted ACGF risk was similar across groups. Donor KDPI and recipient EPTS were stronger predictors of graft failure than AKI stage. Exploratory tolerability analyses showed that early adverse outcomes were driven primarily by recipient age, BMI, dialysis duration, and organ quality, not by donor AKI severity or dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among transplanted kidneys, Stage 3 AKI requiring donor dialysis was associated with higher early DGF but similar adjusted graft survival compared with Stage 2 AKI after accounting for organ quality and recipient risk. These findings reflect outcomes among AKI\u2010affected kidneys accepted for transplantation and should not be generalized to declined or discarded kidneys.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70535","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:56:19Z","timestamp":1775735779000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Kidney Transplants From Donors With Stage 3 Acute Kidney Injury Requiring Dialysis: A National Cohort Study"],"prefix":"10.1111","volume":"40","author":[{"given":"Amber B.","family":"Paulus","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine School of Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurav","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine School of Medicine Virginia Commonwealth University  Richmond Virginia USA"},{"name":"Hume\u2010Lee Transplant Center Virginia Commonwealth University Health System  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet","family":"Gungor","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine University of Arizona College of Medicine  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Toll","sequence":"additional","affiliation":[{"name":"United Network of Organ Sharing (UNOS)  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Lewis","sequence":"additional","affiliation":[{"name":"United Network of Organ Sharing (UNOS)  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Martinez","sequence":"additional","affiliation":[{"name":"United Network of Organ Sharing (UNOS)  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassandra","family":"McCharen","sequence":"additional","affiliation":[{"name":"United Network of Organ Sharing (UNOS)  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wida","family":"Cherikh","sequence":"additional","affiliation":[{"name":"United Network of Organ Sharing (UNOS)  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bekir","family":"Tanriover","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine University of Arizona College of Medicine  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2011.03686.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfx117"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.07.006"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.34971"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.11.030"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0002472021"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.07190715"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2016.08.007"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13190"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14001"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13150"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.08.032"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002634"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000491556"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000592"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10071484"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.13218"},{"key":"e_1_2_12_19_1","volume-title":"2024 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States","author":"United States Renal Data System","year":"2024"},{"key":"e_1_2_12_20_1","article-title":"Tailoring Kidney Transplant Strategies: Unraveling the Impact of Acute Kidney Injury and Preservation Methods Across Different Strata of Kidney Risk","author":"Kaufman D. 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