{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:13:20Z","timestamp":1790108000029,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T00:00:00Z","timestamp":1602115200000},"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":["Nephrology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Compared to Standard Criteria Donors (SCD), Expanded Criteria Donor (ECD) kidneys are associated with poorer outcomes, although pre\u2010transplant biopsy may mitigate risks. This study assessed 5\u2010year outcomes of deceased\u2010donor kidney transplant recipients, comparing recipients of ECD allografts evaluated histologically to recipients of SCD and ECD kidneys assessed clinically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010centre retrospective study. From November 2005 to December 2009 (Era 1), donors were assessed clinically for suitability for kidney donation. From December 2009 to October 2017 (Era 2), kidneys from ECDs and diabetics underwent pre\u2010transplant biopsy and were allocated based on Remuzzi score. Outcomes of Era 1 and 2 recipients were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ECD kidney transplantation increased from 30.4% to 40.0% from Era 1 to 2. Univariable Cox regression, stratified by transplant era, found that 5\u2010year graft loss was highest with Era 1 ECD (HR 2.5, 95% CI 1.1\u20105.5, <jats:italic>P<\/jats:italic> = .027) while graft loss for Era 2 ECD recipients was similar to SCD recipients. There was no difference in 5\u2010year recipient survival. Amongst Era 1 ECD recipients, 51.2% experienced rejection compared to 30.8\u201041.5% for other subgroups. Five\u2010year eGFR was higher with Era 2 ECD at 48.4 (33.3\u201060.7) ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup> compared to 42.2 (35.8\u201057.3) ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup> for Era 1 ECD. However, these differences were not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Introduction of pre\u2010transplant biopsy assessment may be associated with improved outcomes of ECD kidney recipients such that they are now comparable to SCD kidney recipients, with benefits persisting over 5\u2009years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13788","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T17:44:07Z","timestamp":1601315047000},"page":"70-77","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of <scp>pre\u2010transplant<\/scp> biopsy on <scp>5\u2010year<\/scp> outcomes of expanded criteria donor kidney transplantation"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1035-9546","authenticated-orcid":false,"given":"Yun Ting","family":"Yap","sequence":"first","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0884-7076","authenticated-orcid":false,"given":"Quan Yao","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"},{"name":"Medicine Academic Clinical Programme SingHealth Duke\u2010NUS Academic Medical Centre  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5250-855X","authenticated-orcid":false,"given":"Terence","family":"Kee","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"},{"name":"Medicine Academic Clinical Programme SingHealth Duke\u2010NUS Academic Medical Centre  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4033-899X","authenticated-orcid":false,"given":"Chee Yong","family":"Ng","sequence":"additional","affiliation":[{"name":"Medicine Academic Clinical Programme SingHealth Duke\u2010NUS Academic Medical Centre  Singapore"},{"name":"Department of Renal Medicine Changi General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2809-8321","authenticated-orcid":false,"given":"Chang Yin","family":"Chionh","sequence":"additional","affiliation":[{"name":"Medicine Academic Clinical Programme SingHealth Duke\u2010NUS Academic Medical Centre  Singapore"},{"name":"Department of Renal Medicine Changi General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14557"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12135"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.3.s4.11.x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.21.2726"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V123589"},{"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":"10.1111\/ajt.14538"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-47772-7"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2018.06.009"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfz032"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052891"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000543173.47952.4c"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200211150-00014"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03754.x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-145-4-200608150-00004"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.01993.x"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000441361.34103.53"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2008.02370.x"},{"issue":"4","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1097\/TP.0b013e318204bdd7","article-title":"Significance of preimplantation analysis of kidney biopsies from expanded criteria donors in long\u2010term outcome","volume":"91","author":"Navarro MD","year":"2011","journal-title":"Transplantation"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.11.030"},{"issue":"7","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1681\/ASN.V1271538","article-title":"Increased immunogenicity and cause of graft loss of old donor kidneys","volume":"12","author":"Fijter JW","year":"2001","journal-title":"J Am Soc Nephrol"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl637"},{"issue":"1","key":"e_1_2_12_24_1","first-page":"15","article-title":"Significance of the pathologic findings in implantation biopsies for kidney allografts survival","volume":"10","author":"Trailin AV","year":"2019","journal-title":"Int J Organ Transplant Med"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.461"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12709"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4141756"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.5500\/wjt.v6.i1.103"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.13788","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.13788","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.13788","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T08:41:15Z","timestamp":1693816875000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.13788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,8]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1111\/nep.13788"],"URL":"https:\/\/doi.org\/10.1111\/nep.13788","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,8]]},"assertion":[{"value":"2020-08-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}