{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:55:12Z","timestamp":1785779712173,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In October 2024, the Organ Procurement and Transplantation Network (OPTN) removed hepatitis C virus (HCV) positivity and African American\/Black (AA\/B) donor race from the Kidney Donor Profile Index (KDPI) calculation. This study evaluates the early impact of this policy change on kidney utilization during its first year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of OPTN data for organ procurements and adult deceased\u2010donor kidney transplants between November 2023 and October 2025. Donors were stratified by HCV status and race. Kidney utilization and allocation out\u2010of\u2010sequence (AOOS) were compared between pre\u2010policy (November 2023\u2013October 2024) and post\u2010policy (November 2024\u2013October 2025) periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The policy revision was associated with redistribution of HCV+ and AA\/B donor kidneys toward lower KDPI category, with increases of 989% and 144%, respectively, in the 0\u201320% KDPI range. Overall utilization increased among AA\/B (66.9% to 71.5%), non\u2010AA\/B (70.1% to 72.1%), HCV\u2212 (69.6% to 72.0%), and HCV+ donors (70.3% to 72.5%). However, utilization within individual KDPI categories declined for AA\/B and HCV+ donors across most strata, except for the 21\u201334% category among HCV+ donors. AOOS decreased from 20.2% to 16.8% (absolute reduction 3.4%; 95% confidence interval, \u22124.1% to \u22122.6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The policy was associated with increased overall utilization across donor groups. However, gains among AA\/B and HCV+ donors appear primarily driven by redistribution into different allocation sequences rather than improvement in within\u2010category utilization. Reduced AOOS suggests improved allocation efficiency, though findings may be influenced by concurrent regulatory changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70604","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:32:11Z","timestamp":1782275531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of the 2024 Organ Procurement and Transplantation Network Kidney Donor Profile Index Rescoring on Donor Kidney Utilization and Allocation out of Sequence: A one\u2010Year Analysis"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7121-5664","authenticated-orcid":false,"given":"Shengliang","family":"He","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Transplant &amp; Hepatobiliary Surgery Organ Transplant Center University of Iowa Hospital &amp; Clinics  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5989-9685","authenticated-orcid":false,"given":"Christie P.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Iowa Carver College of Medicine  Iowa City Iowa USA"},{"name":"VA Medical Center  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8017-8148","authenticated-orcid":false,"given":"Alan I.","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Transplant &amp; Hepatobiliary Surgery Organ Transplant Center University of Iowa Hospital &amp; Clinics  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"OPTN Minority Affairs Committee \u201cRace and Hepatitis C Status no Longer Included in Calculation Used to Estimate Deceased Donor Kidney Function; Policy Change Anticipated to Increase Equity \u201dhttps:\/\/optn.transplant.hrsa.gov\/news\/race\u2010and\u2010hepatitis\u2010c\u2010status\u2010no\u2010longer\u2010included\u2010in\u2010calculation\u2010used\u2010to\u2010estimate\u2010deceased\u2010donor\u2010kidney\u2010function\u2010policy\u2010change\u2010anticipated\u2010to\u2010increase\u2010equity\/."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2022.12.016"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1705221"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/m17\u20102871"},{"key":"e_1_2_12_6_1","unstructured":"Organ Procurement and Transplantation Network.The New Kidney Allocation System (Kas) Frequently Asked Questions. (2014) Retrieved November 10 2023 fromhttps:\/\/optn.transplant.hrsa.gov\/professionals\/by\u2010topic\/guidance\/thenew\u2010kidneyallocation\u2010system\u2010kas\u2010frequently\u2010asked\u2010questions\/#bookmark5."},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ac620b"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2025.01.015"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2013.08.007"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.06.034"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.12659\/aot.905428"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13743"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/txd.0000000000001827"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.15323"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1681\/asn.0000000000000366"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14719"},{"key":"e_1_2_12_17_1","unstructured":"Health Resources & Services Administration \u201cRefit Kidney Donor Profile Index Without Race and Hepatitis C\u200b Virus \u201dhttps:\/\/www.hrsa.gov\/optn\/policies\u2010bylaws\/public\u2010comment\/refit\u2010kidney\u2010donor\u2010profile\u2010index\u2010without\u2010race\u2010hepatitis\u2010c\u2010virus."},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/emph\/eoab018"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.17197"},{"key":"e_1_2_12_20_1","unstructured":"Health Resources and Services Administration | HRSA(.gov) \u201cAllocation out of OPTN Sequence \u201dhttps:\/\/www.hrsa.gov\/optn\/policies\u2010bylaws\/policy\u2010issues\/allocation\u2010out\u2010of\u2010sequence\u2010aoos."},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2024.09.022"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.0000001043"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2026.02.029"},{"key":"e_1_2_12_24_1","unstructured":"Health Resources and Services Administration | HRSA(.gov) \u201cStrengthening the OPTN Through Data\u2010Driven Decision Making \u201dhttps:\/\/www.hrsa.gov\/optn\u2010modernization\/updates\/august\u20102025."},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2025.02.004"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70604","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:25:07Z","timestamp":1785777907000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/ctr.70604"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70604","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70604"}}