{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:56:22Z","timestamp":1791294982429,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":["Nephrology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Early graft dysfunction after kidney transplantation is heterogeneous, ranging from transient delayed graft function (DGF) to prolonged dialysis dependence and primary nonfunction (PNF). Biomarkers that reflect the severity of early graft injury remain limited. We evaluated whether early post\u2010transplant lactate dehydrogenase (LDH) is associated with the severity of graft dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 339 deceased\u2010donor kidney transplant recipients at a single centre between March 2023 and May 2024. Peak LDH during post\u2010operative Days 1\u20133 was categorized into quartiles and evaluated continuously. Outcomes included DGF, PNF, duration of dialysis dependence and longitudinal eGFR. Multivariable logistic regression adjusted for donor and recipient factors; sensitivity analyses evaluated LDH functional form, maintenance immunosuppression and additional clinical covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DGF occurred in 20.5%, 19.5%, 28.4% and 51.2% of recipients across LDH quartiles Q1\u2013Q4, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), indicating a nonlinear association with risk concentrated at higher LDH values. In adjusted categorical analysis, Q4 had substantially higher odds of DGF than Q1 (adjusted OR\u2009=\u20093.88; 95% CI\u2009=\u20091.82\u20138.28;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas Q2 and Q3 were not significantly different from Q1. Peak LDH remained associated with DGF when modelled continuously (adjusted OR\u2009=\u20091.10 per 100\u2009U\/L; 95% CI\u2009=\u20091.02\u20131.18) and after adjustment for de novo belatacept use. All six PNF events occurred in Q4. Higher LDH was also associated with lower longitudinal eGFR, particularly in Q4.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early post\u2010transplant LDH was associated with the severity of early graft dysfunction, with a nonlinear increase in DGF risk concentrated at higher LDH values. Because LDH is routinely available in the first post\u2010operative days but has only modest stand\u2010alone discrimination, it may be most useful as one component of early risk assessment. Prospective multicentre validation is needed before LDH\u2010based thresholds are used to direct management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70286","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:07:44Z","timestamp":1791292064000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Post\u2010Transplant Lactate Dehydrogenase Stratifies the Severity of Delayed Graft Function After Deceased\u2010Donor Kidney Transplantation"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5575-9693","authenticated-orcid":false,"given":"Samuel","family":"Sultan","sequence":"first","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3015-8354","authenticated-orcid":false,"given":"Mike","family":"Fruscione","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolie","family":"Murcko","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2355-0975","authenticated-orcid":false,"given":"Alexandra","family":"Erhardt","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey","family":"Zendel","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4128-211X","authenticated-orcid":false,"given":"Josue","family":"Alvarez\u2010Casas","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6294-5208","authenticated-orcid":false,"given":"Choli","family":"Hartono","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2709-2350","authenticated-orcid":false,"given":"Vaqar","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu","family":"Luan","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3167-8549","authenticated-orcid":false,"given":"Woojin James","family":"Chon","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-6346","authenticated-orcid":false,"given":"Angelica","family":"Del Vecchio","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Spiegel","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7086-3462","authenticated-orcid":false,"given":"Michael","family":"Wynd","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Chaung","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2297-4272","authenticated-orcid":false,"given":"David","family":"Serur","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5233-2814","authenticated-orcid":false,"given":"Michael","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Hackensack Meridian Health  Hackensack New Jersey 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G.","year":"2008","journal-title":"Nephrology, Dialysis, Transplantation"},{"issue":"8","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1097\/TP.0000000000001409","article-title":"Delayed Graft Function Phenotypes and 12\u2010Month Kidney Transplant Outcomes","volume":"101","author":"Hall I. E.","year":"2017","journal-title":"Transplantation"},{"issue":"11","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1111\/j.1600-6143.2011.03754.x","article-title":"Delayed Graft Function in the Kidney Transplant","volume":"11","author":"Siedlecki A.","year":"2011","journal-title":"American Journal of Transplantation"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"90","article-title":"The Early Diagnosis of Acute Renal Graft Dysfunction: A Challenge We Face. The Role of Novel Biomarkers","volume":"16","author":"Halawa A.","year":"2011","journal-title":"Annals of Transplantation"},{"issue":"9447","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1016\/S0140-6736(04)17406-0","article-title":"Delayed Graft Function in Kidney Transplantation","volume":"364","author":"Perico N.","year":"2004","journal-title":"Lancet"},{"issue":"5","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1093\/ndt\/gfab304","article-title":"Evaluation of Severity of Delayed Graft Function in Kidney Transplant Recipients","volume":"37","author":"Schrezenmeier E.","year":"2022","journal-title":"Nephrology, Dialysis, Transplantation"},{"issue":"1","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1002\/j.2040-4603.2017.tb00741.x","article-title":"Ischemia\/Reperfusion","volume":"7","author":"Kalogeris T.","year":"2017","journal-title":"Comprehensive Physiology"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/9780470122822.ch2","article-title":"Lactate Dehydrogenases: Structure and Function","volume":"37","author":"Everse J.","year":"1973","journal-title":"Advances in Enzymology and Related Areas of Molecular Biology"},{"issue":"1","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1681\/ASN.2009030264","article-title":"IL\u201018 and Urinary NGAL Predict Dialysis and Graft Recovery After Kidney Transplantation","volume":"21","author":"Hall I. E.","year":"2010","journal-title":"Journal of the American Society of Nephrology"},{"issue":"3","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1053\/j.ajkd.2003.10.040","article-title":"Urinary Interleukin\u201018 Is a Marker of Human Acute Tubular Necrosis","volume":"43","author":"Parikh C. R.","year":"2004","journal-title":"American Journal of Kidney Diseases"},{"issue":"10","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"3234","DOI":"10.1016\/j.transproceed.2019.09.009","article-title":"Early Prediction of Graft Outcomes After Kidney Transplantation From Donors After Circulatory Death: Biomarkers and Transplantation Characteristics","volume":"51","author":"Truche A. S.","year":"2019","journal-title":"Transplantation Proceedings"},{"issue":"1","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1177\/1526924816664089","article-title":"Serum Lactate Dehydrogenase Is Elevated in Ischemic Acute Tubular Necrosis but Not in Acute Rejection in Kidney Transplant Patients","volume":"27","author":"Green H.","year":"2017","journal-title":"Progress in Transplantation"},{"issue":"6","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0066776","article-title":"Renal Cortical Lactate Dehydrogenase: A Useful, Accurate, Quantitative Marker of In\u00a0Vivo Tubular Injury and Acute Renal Failure","volume":"8","author":"Zager R. A.","year":"2013","journal-title":"PLoS One"},{"issue":"5","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"F706","DOI":"10.1152\/ajprenal.00628.2020","article-title":"Expression of Lactate Dehydrogenase A and B Isoforms in the Mouse Kidney","volume":"320","author":"Osis G.","year":"2021","journal-title":"American Journal of Physiology. Renal Physiology"},{"issue":"2","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13020485","article-title":"Interpretation of LDH Values After Kidney Transplantation","volume":"13","author":"S\u00e1ndor Z.","year":"2024","journal-title":"Journal of Clinical Medicine"},{"issue":"4","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1056\/NEJMoa1506027","article-title":"Belatacept and Long\u2010Term Outcomes in Kidney Transplantation","volume":"374","author":"Vincenti F.","year":"2016","journal-title":"New England Journal of Medicine"},{"issue":"1","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.kint.2016.02.034","article-title":"Defective Postreperfusion Metabolic Recovery Directly Associates With Incident Delayed Graft Function","volume":"90","author":"Wijermars L. G. M.","year":"2016","journal-title":"Kidney International"},{"issue":"8","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1093\/clinchem\/hvad086","article-title":"Urinary Kidney Injury Biomarkers Are Associated With Ischemia\u2010Reperfusion Injury Severity in Kidney Allograft Recipients","volume":"69","author":"Duijl T. T.","year":"2023","journal-title":"Clinical Chemistry"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.l4923","article-title":"Prediction System for Risk of Allograft Loss in Patients Receiving Kidney Transplants: International Derivation and Validation Study","volume":"366","author":"Loupy A.","year":"2019","journal-title":"BMJ"},{"issue":"1","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/TP.0000000000000256","article-title":"Clusterin in Kidney Transplantation: Novel Biomarkers Versus Serum Creatinine for Early Prediction of Delayed Graft Function","volume":"99","author":"Pianta T. J.","year":"2015","journal-title":"Transplantation"},{"key":"e_1_2_10_22_1","doi-asserted-by":"crossref","DOI":"10.3389\/ti.2023.11590","article-title":"Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria","volume":"36","author":"Afrouzian M.","year":"2023","journal-title":"Transplant International"},{"issue":"9","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"230","DOI":"10.5500\/wjt.v10.i9.230","article-title":"Role of Novel Biomarkers in Kidney Transplantation","volume":"10","author":"Swanson K. J.","year":"2020","journal-title":"World Journal of Transplantation"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70286","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.70286","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:07:48Z","timestamp":1791292068000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/nep.70286"],"URL":"https:\/\/doi.org\/10.1111\/nep.70286","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70286"}}