{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T18:03:22Z","timestamp":1784570602865,"version":"3.55.0"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney transplantation (KT) is the preferred treatment for end-stage renal disease (ESRD) due to its advantages over dialysis. Although the benefits of preemptive KT are well established, the association between pre-transplant dialysis duration and post-transplant outcomes remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between pre-transplant dialysis vintage and post-transplant outcomes in Korean KT recipients using real-world data from a tertiary transplant center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated 1,843 first KT recipients transplanted between 2006\u20132021. Dialysis duration was used as a categorical variable divided by tertiles according to distribution of time of analysis, and preemptive transplantation was categorized as a separate group. Primary outcomes included death-censored graft loss, all-cause mortality and composite outcomes. Survival was assessed using Kaplan\u2013Meier and Cox proportional hazards models at a 95% confidence level. A deceased-donor KT (DDKT) subgroup analysis was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      369 patients underwent preemptive KT, and 1,474 dialysis-exposed recipients were categorized into tertile 1 (n\u2009=\u2009492), tertile 2 (n\u2009=\u2009491), and tertile 3 (n\u2009=\u2009491), with mean pre-transplant dialysis durations of 1.2, 21.4, and 107.6 months, respectively. Compared with preemptive KT, all-cause mortality did not differ in the first or second tertiles but was significantly higher in the third tertile (aHR 3.55; 95% CI 1.43\u20138.81;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). In the overall cohort, the third tertile was also associated with higher risks of death-censored graft failure and the composite outcome. However, in the deceased-donor KT subgroup, death-censored graft failure did not differ significantly across tertiles, and the composite outcome did not show a monotonic dose-response pattern.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prolonged pre-transplant dialysis was associated with a higher risk of all-cause mortality, whereas its association with graft failure was less consistent, particularly among deceased-donor KT recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0352995","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T17:24:41Z","timestamp":1784568281000},"page":"e0352995","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-transplant dialysis vintage and post-transplant outcomes: A retrospective cohort study in Korean kidney transplant recipients"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6155-7318","authenticated-orcid":true,"given":"Eunju","family":"Jang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Yoon","family":"Moon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Seob","family":"Yun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2701-0180","authenticated-orcid":true,"given":"Sun Cheol","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"issue":"23","key":"pone.0352995.ref001","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1056\/NEJM199912023412303","article-title":"Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant","volume":"341","author":"RA Wolfe","year":"1999","journal-title":"N Engl J Med"},{"issue":"12","key":"pone.0352995.ref002","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1111\/tri.14135","article-title":"Declining trend of preemptive kidney transplantation and impact of pretransplant dialysis: a Korean nationwide prospective cohort study","volume":"34","author":"J-H Lim","year":"2021","journal-title":"Transpl Int"},{"issue":"1","key":"pone.0352995.ref003","doi-asserted-by":"crossref","first-page":"17","DOI":"10.23876\/j.krcp.20.003","article-title":"Diagnosis of renal transplant rejection: Banff classification and beyond","volume":"39","author":"HJ Jeong","year":"2020","journal-title":"Kidney Res Clin Pract"},{"key":"pone.0352995.ref004","unstructured":"Korean Network for Organ Sharing (KONOS). 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