The Independent Effects of Procurement Biopsy Findings on 10-Year Outcomes of Extended Criteria Donor Kidney Transplants

Despite being obtained under less than ideal conditions, estimated GS from a procurement biopsy is independently associated with long-term graft survival, above and beyond standard clinical parameters, in ECD transplants. However, the disproportionately high likelihood of discard for kidneys with GS >10% is unjustified. The outsized effect of GS on kidney utilization should be tempered and commensurate with its effect on outcomes.