{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:41:18Z","timestamp":1786372878371,"version":"build-2736575974"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2018,1]]},"abstract":"\n Background and objectives<\/jats:title>\n The fraction of kidneys procured for transplant that are discarded is rising in the United States. Identifying donors from whom only one kidney was discarded allows us to control for donor traits and better assess reasons for organ discard.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n We conducted a retrospective cohort study using United Network for Organ Sharing Standard Transplant Analysis and Research file data to identify deceased donors from whom two kidneys were procured and at least one was transplanted. Unilateral pairs were defined as kidney pairs from a single donor from whom one kidney was discarded (\u201cunilateral discard\u201d) but the other was transplanted (\u201cunilateral transplant\u201d). Organ quality was estimated using the Kidney Donor Risk Index and Kidney Donor Profile Index (KDPI). We compared all-cause graft failure rates for unilateral transplants to those for bilateral transplant Kaplan\u2013Meier methods, and life table methodology was used to evaluate 1-, 2-, 3-, and 5-year survival rates of transplants from bilateral and unilateral donors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared with bilateral donors (\n i.e.<\/jats:italic>\n , both kidneys transplanted) (\n n<\/jats:italic>\n =80,584), unilateral donors (\n i.e.<\/jats:italic>\n , only one kidney transplanted) (\n n<\/jats:italic>\n =7625) had higher mean terminal creatinine (1.3\u00b12.1 mg\/dl versus 1.1\u00b10.9 mg\/dl) and KDPI (67%\u00b125% versus 42%\u00b127%), were older, and were more likely to have hypertension, diabetes, hepatitis C, terminal stroke, or meet Centers for Disease Control and Prevention high-risk donor criteria. Unilateral discards were primarily attributed to factors expected to be similar in both kidneys from a donor: biopsy findings (22%), no interested recipient (13%), and donor history (7%). Anatomic abnormalities (14%), organ damage (11%), and extended ischemia (6%) accounted for about 30% of discards, but were the commonest reasons among low KDPI kidneys. Among kidneys with KDPI\u226560%, there was an incremental difference in allograft survival over time (for unilateral versus bilateral transplants, 1-year survival: 83% versus 87%; 3-year survival: 69% versus 73%; 5-year survival: 51% versus 58%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A large number of discarded kidneys were procured from donors whose contralateral kidneys were transplanted with good post-transplant outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.06550617","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T13:07:00Z","timestamp":1536066420000},"page":"118-127","source":"Crossref","is-referenced-by-count":52,"title":["Characteristics and Performance of Unilateral Kidney Transplants from Deceased Donors"],"prefix":"10.2215","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1823-0117","authenticated-orcid":false,"given":"Syed Ali","family":"Husain","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine and"},{"name":"The Columbia University Renal Epidemiology Group, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana C.","family":"Chiles","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine and"},{"name":"The Columbia University Renal Epidemiology Group, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samnang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen O.","family":"Pastan","sequence":"additional","affiliation":[{"name":"Renal Division, Department of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel E.","family":"Patzer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emory University School of Medicine, Atlanta, Georgia;"},{"name":"Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bekir","family":"Tanriover","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd E.","family":"Ratner","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Columbia University Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5305-9685","authenticated-orcid":false,"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine and"},{"name":"The Columbia University Renal Epidemiology Group, New York, New York;"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,12,7]]},"reference":[{"key":"B1-20230813","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":"Wolfe","year":"1999","journal-title":"N Engl J Med"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1681\/ASN.V115917","article-title":"Comparison of mortality risk for dialysis patients and cadaveric first renal transplant recipients in Ontario, 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