{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:13:12Z","timestamp":1790107992665,"version":"4.0.1"},"reference-count":55,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: This study aimed to assess the association between the percentage of glomerulosclerosis (GS) in procurement allograft biopsies from high-risk deceased donor and graft outcomes in kidney transplant recipients. Methods: The UNOS database was used to identify deceased-donor kidneys with a kidney donor profile index (KDPI) score &gt; 85% from 2005 to 2014. Deceased donor kidneys were categorized based on the percentage of GS: 0\u201310%, 11\u201320%, &gt;20% and no biopsy performed. The outcome included death-censored graft survival, patient survival, rate of delayed graft function, and 1-year acute rejection. Results: Of 22,006 kidneys, 91.2% were biopsied showing 0\u201310% GS (58.0%), 11\u201320% GS (13.5%), &gt;20% GS (19.7%); 8.8% were not biopsied. The rate of kidney discard was 48.5%; 33.6% in 0\u201310% GS, 68.9% in 11\u201320% GS, and 77.4% in &gt;20% GS. 49.8% of kidneys were discarded in those that were not biopsied. Death-censored graft survival at 5 years was 75.8% for 0\u201310% GS, 70.9% for &gt;10% GS, and 74.8% for the no biopsy group. Among kidneys with &gt;10% GS, there was no significant difference in death-censored graft survival between 11\u201320% GS and &gt;20% GS. Recipients with &gt;10% GS had an increased risk of graft failure (HR = 1.27, p &lt; 0.001), compared with 0\u201310% GS. There was no significant difference in patient survival, acute rejection at 1-year, and delayed graft function between 0% and 10% GS and &gt;10% GS. Conclusion: In &gt;85% KDPI kidneys, our study suggested that discard rates increased with higher percentages of GS, and GS &gt;10% is an independent prognostic factor for graft failure. Due to organ shortage, future studies are needed to identify strategies to use these marginal kidneys safely and improve outcomes.<\/jats:p>","DOI":"10.3390\/jcm9051469","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T10:27:19Z","timestamp":1589452039000},"page":"1469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-9711","authenticated-orcid":false,"given":"Wisit","family":"Cheungpasitporn","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charat","family":"Thongprayoon","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5234-6722","authenticated-orcid":false,"given":"Pradeep K","family":"Vaitla","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Api","family":"Chewcharat","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panupong","family":"Hansrivijit","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle, Harrisburg, PA 17105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicitas L.","family":"Koller","sequence":"additional","affiliation":[{"name":"Department of Transplant and Hepatobiliary Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1814-7003","authenticated-orcid":false,"given":"Michael A","family":"Mao","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL 32224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Bathini","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Arizona, Tucson, AZ 85721, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohail Abdul","family":"Salim","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreelatha","family":"Katari","sequence":"additional","affiliation":[{"name":"Renal Transplant Program, School of Medicine\/Saint Luke\u2019s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee S","family":"Cummings","sequence":"additional","affiliation":[{"name":"Renal Transplant Program, School of Medicine\/Saint Luke\u2019s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddie","family":"Island","sequence":"additional","affiliation":[{"name":"Renal Transplant Program, School of Medicine\/Saint Luke\u2019s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jameson","family":"Forster","sequence":"additional","affiliation":[{"name":"Renal Transplant Program, School of Medicine\/Saint Luke\u2019s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Napat","family":"Leeaphorn","sequence":"additional","affiliation":[{"name":"Renal Transplant Program, School of Medicine\/Saint Luke\u2019s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/ajt.14557","article-title":"OPTN\/SRTR 2016 annual data report: Kidney","volume":"18","author":"Hart","year":"2018","journal-title":"Am. J. Transp."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1056\/NEJM199404283301703","article-title":"Infusions of donor leukocytes to treat Epstein-Barr virus-associated lymphoproliferative disorders after allogeneic bone marrow transplantation","volume":"330","author":"Papadopoulos","year":"1994","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1111\/ajt.15099","article-title":"Trends among kidney transplant candidates in the United States: Sifting through the tea leaves","volume":"19","author":"Gupta","year":"2019","journal-title":"Am. J. Transp."},{"key":"ref_4","unstructured":"Cecka, J.M. (2008). Kidney transplantation in the United States. Clin. Transp., 1\u201318."},{"key":"ref_5","unstructured":"Andre, M., Huang, E., Everly, M., and Bunnapradist, S. (2014). The UNOS renal transplant registry: Review of the last decade. Clin Transp., 1\u201312."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/ajt.14124","article-title":"OPTN\/SRTR 2015 annual data report: Kidney","volume":"17","author":"Hart","year":"2017","journal-title":"Am. J. Transp."},{"key":"ref_7","unstructured":"United States Renal Data System (2015). 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.kint.2018.02.016","article-title":"Factors leading to the discard of deceased donor kidneys in the United States","volume":"94","author":"Mohan","year":"2018","journal-title":"Kidney Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1111\/ajt.15325","article-title":"Variation in use of procurement biopsies and its implications for discard of deceased donor kidneys recovered for transplantation","volume":"19","author":"Lentine","year":"2019","journal-title":"Am. J. Transp."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1034\/j.1600-6143.3.s4.11.x","article-title":"Expanded criteria donors for kidney transplantation","volume":"4","author":"Metzger","year":"2003","journal-title":"Am. J. Transp."},{"key":"ref_11","doi-asserted-by":"crossref","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":"ref_12","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/ajt.15274","article-title":"OPTN\/SRTR 2017 annual data report: Kidney","volume":"19","author":"Hart","year":"2019","journal-title":"Am. J. Transp."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1681\/ASN.2015010023","article-title":"New solutions to reduce discard of kidneys donated for transplantation","volume":"27","author":"Reese","year":"2016","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2202","DOI":"10.1111\/ajt.13769","article-title":"Changes in discard rate after the introduction of the kidney donor profile index (KDPI)","volume":"16","author":"Bae","year":"2016","journal-title":"Am. J. Transp."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2708","DOI":"10.1111\/ajt.14712","article-title":"Hard-to-place kidney offers: Donor- and system-level predictors of discard","volume":"18","author":"Narvaez","year":"2018","journal-title":"Am. J. Transp."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/ajt.14449","article-title":"Kidney allograft offers: Predictors of turndown and the impact of late organ acceptance on allograft survival","volume":"18","author":"Cohen","year":"2018","journal-title":"Am. J. Transp."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3109","DOI":"10.1681\/ASN.2016121330","article-title":"Association between reperfusion renal allograft biopsy findings and transplant outcomes","volume":"28","author":"Mohan","year":"2017","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_18","doi-asserted-by":"crossref","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":"ref_19","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/ajt.13929","article-title":"Banff histopathological consensus criteria for preimplantation kidney biopsies","volume":"17","author":"Liapis","year":"2017","journal-title":"Am. J. Transp."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e373","DOI":"10.1097\/TXD.0000000000000816","article-title":"Procurement biopsy findings versus kidney donor risk index for predicting renal allograft survival","volume":"4","author":"Hall","year":"2018","journal-title":"Transp. Direct"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"562","DOI":"10.2215\/CJN.07610713","article-title":"The role of procurement biopsies in acceptance decisions for kidneys retrieved for transplant","volume":"9","author":"Kasiske","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1097\/TP.0000000000001539","article-title":"Diagnosing the decades-long rise in the deceased donor kidney discard rate in the United States","volume":"101","author":"Stewart","year":"2017","journal-title":"Transplantation"},{"key":"ref_23","doi-asserted-by":"crossref","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. Transp."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1111\/j.1600-6143.2008.02157.x","article-title":"Determinants of discard of expanded criteria donor kidneys: Impact of biopsy and machine perfusion","volume":"8","author":"Sung","year":"2008","journal-title":"Am. J. Transp."},{"key":"ref_25","doi-asserted-by":"crossref","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":"ref_26","doi-asserted-by":"crossref","first-page":"443","DOI":"10.2215\/CJN.00470114","article-title":"Procurement biopsies in kidneys retrieved for transplantation","volume":"9","author":"Malek","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1097\/01.tp.0000282868.86529.31","article-title":"Donor biopsy and kidney transplant outcomes: An analysis using the organ procurement and transplantation network\/united network for organ sharing (OPTN\/UNOS) database","volume":"84","author":"Bajwa","year":"2007","journal-title":"Transplantation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1097\/01.TP.0000123080.19145.59","article-title":"Reasons for non-use of recovered kidneys: The effect of donor glomerulosclerosis and creatinine clearance on graft survival","volume":"77","author":"Edwards","year":"2004","journal-title":"Transplantation"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.transproceed.2004.12.108","article-title":"Renal biopsy donor group: The influence of glomerulosclerosis on transplant outcomes","volume":"37","author":"Cicciarelli","year":"2005","journal-title":"Transplant. Proc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1016\/S1470-2045(18)30673-9","article-title":"Avelumab versus docetaxel in patients with platinum-treated advanced non-small-cell lung cancer (JAVELIN Lung 200): An open-label, randomised, phase 3 study","volume":"19","author":"Barlesi","year":"2018","journal-title":"Lancet Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1159\/000491631","article-title":"Acute kidney injury after pembrolizumab-induced adrenalitis and adrenal insufficiency","volume":"8","author":"Hanna","year":"2018","journal-title":"Case Rep. Nephrol. Dial."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1159\/000499452","article-title":"Making procurement biopsies important again for kidney transplant allocation","volume":"142","author":"Angeletti","year":"2019","journal-title":"Nephron"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1097\/01.tp.0000216284.81604.d4","article-title":"Could more effective use of kidneys recovered from older deceased donors result in more kidney transplants for older patients?","volume":"81","author":"Cecka","year":"2006","journal-title":"Transplantation"},{"key":"ref_34","doi-asserted-by":"crossref","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":"ref_35","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1097\/00007890-200004150-00024","article-title":"Biopsy of marginal donor kidneys: Correlation of histologic findings with graft dysfunction","volume":"69","author":"Randhawa","year":"2000","journal-title":"Transplantation"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3162","DOI":"10.1681\/ASN.2014080752","article-title":"Glomerular aging and focal global glomerulosclerosis: A podometric perspective","volume":"26","author":"Hodgin","year":"2015","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1159\/000486907","article-title":"Tick-tock chimes the kidney clock\u2014From biology of renal ageing to clinical applications","volume":"43","author":"Rowland","year":"2018","journal-title":"Kidney Blood Press. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1111\/ajt.12928","article-title":"The Kidney Donor Profile Index (KDPI) of marginal donors allocated by standardized pretransplant donor biopsy assessment: Distribution and association with graft outcomes","volume":"14","author":"Gandolfini","year":"2014","journal-title":"Am. J. Transp."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1681\/ASN.2018050531","article-title":"Projecting ESRD incidence and prevalence in the United States through 2030","volume":"30","author":"McCullough","year":"2019","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s40472-017-0138-9","article-title":"Measuring transplant center performance: The goals are not controversial but the methods and consequences can be","volume":"4","author":"Jay","year":"2017","journal-title":"Curr. Transp."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Thongprayoon, C., Hansrivijit, P., Leeaphorn, N., Acharya, P., Torres-Ortiz, A., Kaewput, W., Kovvuru, K., Kanduri, S.R., Bathini, T., and Cheungpasitporn, W. (2020). Recent advances and clinical outcomes of kidney transplantation. J. Clin. Med., 9.","DOI":"10.3390\/jcm9041193"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Thongprayoon, C., Kaewput, W., Kovvuru, K., Hansrivijit, P., Kanduri, S.R., Bathini, T., Chewcharat, A., Leeaphorn, N., Gonzalez-Suarez, M.L., and Cheungpasitporn, W. (2020). Promises of big data and artificial intelligence in nephrology and transplantation. J. Clin. Med., 9.","DOI":"10.3390\/jcm9041107"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1111\/ajt.15723","article-title":"Outcomes of kidney retransplantation after graft loss as a result of BK virus nephropathy in the era of newer immunosuppressant agents","volume":"20","author":"Leeaphorn","year":"2020","journal-title":"Am. J. Transp."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e13194","DOI":"10.1111\/ctr.13194","article-title":"De novo donor-specific antibody following BK nephropathy: The incidence and association with antibody-mediated rejection","volume":"32","author":"Cheungpasitporn","year":"2018","journal-title":"Clin. Transp."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e13190","DOI":"10.1111\/ctr.13190","article-title":"The impact of kidney donor profile index on delayed graft function and transplant outcomes: A single-center analysis","volume":"32","author":"Zens","year":"2018","journal-title":"Clin. Transp."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1097\/TP.0000000000001405","article-title":"Survival benefit in older patients associated with earlier transplant with high KDPI kidneys","volume":"101","author":"Jay","year":"2017","journal-title":"Transplantation"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1111\/ajt.12830","article-title":"Survival benefit of primary deceased donor transplantation with high-KDPI kidneys","volume":"14","author":"Massie","year":"2014","journal-title":"Am. J. Transp."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3159","DOI":"10.1111\/ajt.14459","article-title":"Long-term outcome of renal transplantation from octogenarian donors: A multicenter controlled study","volume":"17","author":"Ruggenenti","year":"2017","journal-title":"Am. J. Transp."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1097\/01.tp.0000266579.11595.95","article-title":"Dual kidney transplantation: A case-control comparison with single kidney transplantation from standard and expanded criteria donors","volume":"83","author":"Moore","year":"2007","journal-title":"Transplantation"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/01.tp.0000296855.44445.af","article-title":"Outcomes of dual adult kidney transplants in the United States: An analysis of the OPTN\/UNOS database","volume":"85","author":"Gill","year":"2008","journal-title":"Transplantation"},{"key":"ref_51","doi-asserted-by":"crossref","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":"ref_52","doi-asserted-by":"crossref","unstructured":"Lee, K.W., Park, J.B., Cha, S.R., Lee, S.H., Chung, Y.J., Yoo, H., Kim, K., and Kim, S.J. (2020). Dual kidney transplantation offers a safe and effective way to use kidneys from deceased donors older than 70 years. BMC Nephrol., 21.","DOI":"10.1186\/s12882-019-1664-8"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"418","DOI":"10.2215\/CJN.09180819","article-title":"Personalizing donor kidney selection: Choosing the right donor for the right recipient","volume":"15","author":"Foley","year":"2019","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1097\/TP.0000000000001018","article-title":"Zero-time renal transplant biopsies: A comprehensive review","volume":"100","author":"Naesens","year":"2016","journal-title":"Transplantation"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1097\/00007890-199904270-00013","article-title":"Outcome of kidney transplantation from high-risk donors is determined by both structure and function","volume":"67","author":"Karpinski","year":"1999","journal-title":"Transplantation"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/5\/1469\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:28:38Z","timestamp":1760174918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/5\/1469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,14]]},"references-count":55,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["jcm9051469"],"URL":"https:\/\/doi.org\/10.3390\/jcm9051469","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,14]]}}}