{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:13:19Z","timestamp":1790107999852,"version":"4.0.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl Int"],"abstract":"<jats:p>The increasing comorbidity of kidney transplant (KT) donors make it necessary to develop scores to correctly assess the quality of kidney grafts. This study analyzes the usefulness of the preimplantation biopsy and the Kidney Donor Profile Index (KDPI) as indicators of KT survival from expanded criteria donors (ECD). Retrospective study of KT in our center between January 2010 to June 2019 who received a kidney from an ECD and underwent a preimplantation biopsy. 266 KT were included. Graft survival was categorized by KDPI quartiles: Q1 = 86%, Q2 = 95%, Q3 = 99% and Q4 = 100%. KT from KDPI Q1 presented better survival (<jats:italic>p<\/jats:italic> = 0.003) and Q4 donors had worse renal function (<jats:italic>p<\/jats:italic> = 0.018) and poorer glomerular filtration rate (3rd month; <jats:italic>p<\/jats:italic> = 0.017, 1st year; <jats:italic>p<\/jats:italic> = 0.010). KT survival was analyzed according to KDPI quartile and preimplantation biopsy score simultaneously: Q1 donors with biopsy score \u22643 had the best survival, especially comparing against Q3 with a biopsy score &amp;gt;3 and Q4 donors (<jats:italic>p<\/jats:italic> = 0.014). In multivariable analysis, hyaline arteriopathy, glomerulosclerosis, and KDPI Q4 were predictors for graft survival. High KDPI and a greater histological injury in the preimplantation biopsy, especially glomerular and vascular lesions, were related to a higher rate of KT loss from ECD.<\/jats:p>","DOI":"10.3389\/ti.2022.10056","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T04:11:15Z","timestamp":1654488675000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation of Expanded Criteria Donors Using the Kidney Donor Profile Index and the Preimplantation Renal Biopsy"],"prefix":"10.3389","volume":"35","author":[{"given":"F.","family":"Villanego","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. A.","family":"Vigara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Cazorla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Naranjo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Atienza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. M.","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. E.","family":"Montero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C.","family":"Minguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Mazuecos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"B1","volume-title":"Donation and Transplant Activity Reports [Internet]","year":"2020"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1097\/00007890-200211150-00014","article-title":"Donor Characteristics Associated with Reduced Graft Survival: an Approach to Expanding the Pool of Kidney Donors1","volume":"74","author":"Port","year":"2002","journal-title":"Transplantation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.trre.2015.04.002","article-title":"New Strategies for Evaluating the Quality of Kidney Grafts from Elderly Donors","volume":"29","author":"Wohlfahrtova","year":"2015","journal-title":"Transplant Rev"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1093\/ndt\/gfu304","article-title":"Is the Kidney Donor Risk Index a Step Forward in the Assessment of Deceased Donor Kidney Quality?","volume":"30","author":"Lee","year":"2015","journal-title":"Nephrol Dial Transpl"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.1681\/asn.2013070784","article-title":"New National Allocation Policy for Deceased Donor Kidneys in the United States and Possible Effect on Patient Outcomes","volume":"25","author":"Israni","year":"2014","journal-title":"J Am Soc Nephrol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.nefroe.2018.06.014","article-title":"Does the Kidney Donor Profile Index (KDPI) Predict Graft and Patient Survival in a Spanish Population?","volume":"38","author":"Calvillo-Arbizu","year":"2018","journal-title":"Nefrolog\u00eda (English Edition)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.nefroe.2017.12.003","article-title":"Validation of KDRI\/KDPI for the Selection of Expanded Criteria Kidney Donors","volume":"38","author":"del Moral Mart\u00edn","year":"2018","journal-title":"Nefrolog\u00eda (English Edition)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.nefro.2016.05.005","article-title":"Kidney Donor Profile Index: Can it Be Extrapolated to Our Environment?","volume":"36","author":"Pascual","year":"2016","journal-title":"Nefrolog\u00eda (English Edition)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1016\/j.nefro.2018.03.003","article-title":"Usefulness of the KDPI in Spain: A Comparison with Donor Age and Definition of Standard\/expanded Criteria Donor","volume":"38","author":"Arias-Cabrales","year":"2018","journal-title":"Nefrolog\u00eda"},{"key":"B10","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1097\/01.tp.0000441361.34103.53","article-title":"Preoperative Assessment of the Deceased-Donor Kidney","volume":"97","author":"Dare","year":"2014","journal-title":"Transplantation"},{"key":"B11","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1056\/nejmoa052891","article-title":"Long-term Outcome of Renal Transplantation from Older Donors","volume":"354","author":"Remuzzi","year":"2006","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1016\/j.transproceed.2020.09.002","article-title":"Deceased-Donor Kidney Biopsy Scoring Systems for Predicting Future Graft Function: A Comparative Study","volume":"53","author":"Chen","year":"2021","journal-title":"Transplant Proc"},{"key":"B13","first-page":"385","article-title":"Guidelines for Indicating, Obtaining, Processing and Evaluating Kidney Biopsies","volume":"28","author":"Ser\u00f3n","year":"2008","journal-title":"Nefrologia"},{"key":"B14","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1097\/TP.0b013e318204bdd7","article-title":"Significance of Preimplantation Analysis of Kidney Biopsies from Expanded Criteria Donors in Long-Term Outcome","volume":"91","author":"Navarro","year":"2011","journal-title":"Transplantation"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1111\/ajt.13213","article-title":"The Donor Kidney Biopsy and its Implications in Predicting Graft Outcomes: A Systematic Review","volume":"15","author":"Wang","year":"2015","journal-title":"Am J Transpl"},{"key":"B16","doi-asserted-by":"publisher","first-page":"461","DOI":"10.7326\/0003-4819-130-6-199903160-00002","article-title":"A More Accurate Method to Estimate Glomerular Filtration Rate from Serum Creatinine: A New Prediction Equation","volume":"130","author":"Levey","year":"1999","journal-title":"Ann Intern Med"},{"key":"B17","volume-title":"KDPI Calculator [Internet]","year":"2020"},{"key":"B18","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.nefro.2015.10.009","article-title":"Prognostic Utility of Preimplantation Kidney Biopsy from Deceased Older Donors in First Year post-transplant Renal Function","volume":"36","author":"Amen\u00e1bar","year":"2016","journal-title":"Nefrolog\u00eda (English Edition)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.1016\/j.transproceed.2019.02.023","article-title":"Pretransplant Biopsy of Marginal Kidneys: Is it Necessary?","volume":"51","author":"Teixeira","year":"2019","journal-title":"Transplant Proc"},{"key":"B20","doi-asserted-by":"publisher","first-page":"110","DOI":"10.5500\/wjt.v8.i4.110","article-title":"Renal Transplants from Older Deceased Donors: Is Pre-implantation Biopsy Useful? A Monocentric Observational Clinical Study","volume":"8","author":"Colussi","year":"2018","journal-title":"World J Transplant"},{"key":"B21","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1097\/01.tp.0000437428.12356.4a","article-title":"Pre-implant Biopsy Predicts Outcome of Single-Kidney Transplantation Independent of Clinical Donor Variables","volume":"97","author":"Hofer","year":"2014","journal-title":"Transplantation"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1097\/TP.0b013e3181a4ebd2","article-title":"Kidneys from Deceased Donors More Than 75 Years Perform Acceptably after Transplantation","volume":"87","author":"Foss","year":"2009","journal-title":"Transplantation"},{"key":"B23","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1097\/01.TP.0000044361.74625.E7","article-title":"The Presence of Glomerular Sclerosis at Time Zero Has a Significant Impact on Function after Cadaveric Renal Transplantation","volume":"75","author":"Escofet","year":"2003","journal-title":"Transplantation"},{"key":"B24","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1097\/00007890-199508270-00006","article-title":"Glomerulosclerosis as a Determinant of Posttransplant Function of Older Donor Renal Allografts","volume":"60","author":"Gaber","year":"1995","journal-title":"Transplantation"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1097\/00007890-200004150-00024","article-title":"Biopsy of Marginal Donor Kidneys: Correlation of Histologic Findings with Graft Dysfunction1","volume":"69","author":"Randhawa","year":"2000","journal-title":"Transplantation"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1852","DOI":"10.1016\/j.ajpath.2012.01.038","article-title":"Arteriolar Lesions in Renal Transplant Biopsies","volume":"180","author":"Br\u00f6cker","year":"2012","journal-title":"Am J Pathol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.2215\/CJN.04150418","article-title":"Procurement Biopsies in the Evaluation of Deceased Donor Kidneys","volume":"13","author":"Carpenter","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1016\/j.acthis.2019.05.002","article-title":"Cryoembedder, Automatic Processor\/stainer, Liquid Nitrogen Freezing, and Manual Staining for Frozen Section Examination: A Comparative Study","volume":"121","author":"Renne","year":"2019","journal-title":"Acta Histochem"},{"key":"B29","doi-asserted-by":"publisher","first-page":"175","DOI":"10.5414\/CN108858","article-title":"KDPI Score Is a strong Predictor of Future Graft Function: Moderate KDPI (35 - 85) and High KDPI (> 85) Grafts Yield Similar Graft Function and Survival","volume":"86","author":"Gupta","year":"2016","journal-title":"Clin Nephrol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e887","DOI":"10.7759\/cureus.887","article-title":"Trends in Usage and Outcomes for Expanded Criteria Donor Kidney Transplantation in the United States Characterized by Kidney Donor Profile Index","volume":"8","author":"Rege","year":"2016","journal-title":"Cureus"},{"key":"B31","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1111\/tri.12966","article-title":"Histopathological Evaluation of Pretransplant Donor Biopsies in Expanded Criteria Donors with High Kidney Donor Profile index: a Retrospective Observational Cohort Study","volume":"30","author":"S\u00e1nchez-Escuredo","year":"2017","journal-title":"Transpl Int"},{"key":"B32","volume-title":"A Guide to Calculating and Interpreting the Estimated Post-Transplant Survival (EPTS) Score Used in the Kidney Allocation System (KAS) [Internet]","year":"2021"},{"key":"B33","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1097\/TP.0000000000001508","article-title":"Dual Kidney Transplantation: Is It Worth It?","volume":"101","author":"Snanoudj","year":"2017","journal-title":"Transplantation"}],"container-title":["Transplant International"],"original-title":[],"link":[{"URL":"https:\/\/www.frontierspartnerships.org\/articles\/10.3389\/ti.2022.10056\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T04:11:21Z","timestamp":1654488681000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontierspartnerships.org\/articles\/10.3389\/ti.2022.10056\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,6]]},"references-count":33,"alternative-id":["10.3389\/ti.2022.10056"],"URL":"https:\/\/doi.org\/10.3389\/ti.2022.10056","relation":{},"ISSN":["1432-2277"],"issn-type":[{"value":"1432-2277","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,6]]},"article-number":"10056"}}