{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T11:34:23Z","timestamp":1793100863646,"version":"4.5.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","funder":[{"name":"OrganX"},{"name":"OrganX"},{"name":"Poste d'accueil AP-HP\/SCAI"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The integrative box showed accurate discrimination, overall fit, and clinical utility in 3866 kidney transplant recipients from North America.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Predictive performance was maintained in African American and non-African American kidney transplant recipients.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>These results support the robustness of the integrative box as a risk prediction tool.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The integrative box (iBox) is a validated prognostication system that predicts long-term death-censored graft loss in kidney transplant recipients, but its performance in the specific population of African American recipients has not been fully studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter study including 3866 kidney transplant recipients from North America, of whom 1040 (27%) were African American, to assess the impact of race on the iBox's performance in predicting graft loss. Discrimination, calibration, overall fit, and clinical utility were evaluated in the whole cohort and in African American and non-African American recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Performance metrics for the prediction of graft loss were similar in both subgroups in discrimination (C-index 0.80 [95% confidence interval (CI), 0.77 to 0.83] in African American recipients and 0.83 [95% CI, 0.81 to 0.85] in non-African American recipients,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.07) and observed\/expected ratios (1.08 [95% CI, 0.95 to 1.23] and 0.99 [95% CI, 0.88 to 1.10], respectively,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.28). No significant interaction between iBox score values and race was found in multivariable analysis stratified by transplant center (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.24 for the interaction term). The results were consistent between the subgroups regardless of the equation used to estimate eGFR (Kidney Recipient Specific, CKD-Epidemiology Collaboration, or Modification of Diet in Renal Disease), but with variations in calibration across equations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The iBox prognostication system showed accurate discrimination, overall fit, and clinical utility up to 7 years after risk evaluation in African American and non-African American kidney transplant recipients, supporting its robustness in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial registry name and registration number:<\/jats:title>\n                    <jats:p>ClinicalTrials.gov, NCT03474003.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.0000001247","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:00:59Z","timestamp":1789056059000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Performance of the Integrative Box (iBox) Prognostication System in African American Kidney Transplant Recipients"],"prefix":"10.1681","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8408-0893","authenticated-orcid":false,"given":"Agathe","family":"Truchot","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris Cit\u00e9, INSERM, PARCC U970, Paris Institute for Transplantation and Organ Regeneration (PITOR), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9031-1862","authenticated-orcid":false,"given":"Yannis","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris Cit\u00e9, INSERM, PARCC U970, Paris Institute for Transplantation and Organ Regeneration (PITOR), Paris, France"},{"name":"Department of Nephrology, Tenon Hospital, Assistance Publique-H\u00f4pitaux de Paris, Sorbonne Universit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Raynaud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris Cit\u00e9, INSERM, PARCC U970, Paris Institute for Transplantation and Organ Regeneration (PITOR), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6284-3757","authenticated-orcid":false,"given":"Olivier","family":"Aubert","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplantation, Necker Hospital, Assistance Publique-H\u00f4pitaux de Paris, Universit\u00e9 Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3450-0033","authenticated-orcid":false,"given":"Gillian","family":"Divard","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris Cit\u00e9, INSERM, PARCC U970, Paris Institute for Transplantation and Organ Regeneration (PITOR), Paris, France"},{"name":"Department of Nephrology, Saint-Louis Hospital, Assistance Publique-H\u00f4pitaux de Paris, Universit\u00e9 Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0079-0697","authenticated-orcid":false,"given":"Thibaut","family":"Thalamas","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris Cit\u00e9, INSERM, PARCC U970, Paris Institute for Transplantation and Organ Regeneration (PITOR), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0876-0069","authenticated-orcid":false,"given":"Brad","family":"Astor","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3326-8583","authenticated-orcid":false,"given":"Didier","family":"Mandelbrot","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1667-7465","authenticated-orcid":false,"given":"Sandesh","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-1888","authenticated-orcid":false,"given":"Kenneth A.","family":"Newell","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6573-2649","authenticated-orcid":false,"given":"Christian P.","family":"Larsen","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0267-9665","authenticated-orcid":false,"given":"Geeta","family":"Karadkhele","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-7135","authenticated-orcid":false,"given":"Babak","family":"Orandi","sequence":"additional","affiliation":[{"name":"Departments of Surgery and of Population Health, New York University Grossman School of Medicine and Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9344-9928","authenticated-orcid":false,"given":"John J.","family":"Friedewald","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1919-1970","authenticated-orcid":false,"given":"Gaurav","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enver","family":"Akalin","sequence":"additional","affiliation":[{"name":"Renal Division Montefiore Medical Center, Albert Einstein College of Medicine, Kidney Transplantation Program, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0456-8635","authenticated-orcid":false,"given":"Stanley C.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Comprehensive Transplant Center, Cedars Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9957-639X","authenticated-orcid":false,"given":"Arthur J.","family":"Matas","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9665-330X","authenticated-orcid":false,"given":"Miklos Z.","family":"Molnar","sequence":"additional","affiliation":[{"name":"Transplant Institute, University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6090-2183","authenticated-orcid":false,"given":"Junji","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6095-4644","authenticated-orcid":false,"given":"Katalin","family":"Fornadi","sequence":"additional","affiliation":[{"name":"Division of Transplantation and Advanced Hepatobiliary Surgery, Department of Surgery, 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