{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:36:31Z","timestamp":1784662591192,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017245","name":"Hennepin Healthcare Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017245","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Following implementation of the U.S. Kidney Allocation System (KAS) in 2014, deceased donor kidneys with a kidney donor profile index (KDPI)\u2009&lt;\u200935% are prioritized for allocation to pediatric candidates. Early post\u2010KAS data suggested this prioritization may have led to more frequent delayed graft function compared to pre\u2010KAS, when pediatric allocation priority was based on donor age\u2009&lt;\u200935\u2009years. We sought to understand the impact of this allocation change on longer\u2010term pediatric kidney transplant outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used SRTR data to identify all deceased donor kidney transplants with pediatric recipients during two eras: \u201cPre\u2010KAS\u201d (12\/1\/2009\u201311\/30\/2014) and \u201cKAS\u201d (12\/1\/2015\u201311\/30\/2020). We used Cox proportional hazards models to calculate the association between study era and all\u2010cause graft failure (graft failure or death) after adjusting for recipient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 4502 included transplants, 2175 (48%) were in the pre\u2010KAS era and 2327 (52%) in the KAS era. KAS\u2010era donors were older (median age 23\u2009years, 13% age\u2009\u2265\u200935\u2009years vs. median age 21, 1% age\u2009\u2265\u200935\u2009years), less likely to have diabetes and hypertension, and had lower serum creatinine. Transplantation during the KAS era was associated with a lower hazard of graft failure after adjusting for recipient characteristics (adjusted HR\n                      <jats:sub>0.69<\/jats:sub>\n                      0.79\n                      <jats:sub>0.91<\/jats:sub>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Results were similar in sensitivity analyses limited to recipients &lt;\u200910\u2009years old and recipients alive with a functioning graft 90\u2009days post\u2010transplant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>KDPI\u2010based prioritization of kidneys for pediatric allocation was associated with a lower risk of graft failure compared to donor age\u2010based prioritization. Further refining donor risk scores may enable additional improvements in graft survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70273","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T10:40:51Z","timestamp":1769596851000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pediatric Kidney Transplant Outcomes After Kidney Donor Profile Index\u2010Based Organ Prioritization"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1823-0117","authenticated-orcid":false,"given":"Syed Ali","family":"Husain","sequence":"first","affiliation":[{"name":"Department of Surgery NYU Langone Health  New York New York USA"},{"name":"Department of Medicine, Division of Nephrology NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6764-4842","authenticated-orcid":false,"given":"Darren","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Surgery NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-7135","authenticated-orcid":false,"given":"Babak J.","family":"Orandi","sequence":"additional","affiliation":[{"name":"Department of Surgery NYU Langone Health  New York New York USA"},{"name":"Department of Medicine, Division of Nephrology NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8867-998X","authenticated-orcid":false,"given":"Marissa","family":"Lipton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Nephrology Hassenfeld Children's Hospital at NYU Langone  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6720-277X","authenticated-orcid":false,"given":"Laura","family":"Malaga\u2010Dieguez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Nephrology Hassenfeld Children's Hospital at NYU Langone  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0098-8816","authenticated-orcid":false,"given":"Sunjae","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Surgery NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4239-1252","authenticated-orcid":false,"given":"Macey L.","family":"Levan","sequence":"additional","affiliation":[{"name":"Department of Surgery NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4530-8917","authenticated-orcid":false,"given":"Sommer E.","family":"Gentry","sequence":"additional","affiliation":[{"name":"Department of Surgery NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-4801","authenticated-orcid":false,"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Surgery NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5288-5125","authenticated-orcid":false,"given":"Allan B.","family":"Massie","sequence":"additional","affiliation":[{"name":"Department of Surgery NYU Langone Health  New York New York 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