Trend in Utilization and Transplant Outcomes of COVID-19-Positive Deceased-Donor Kidneys
Bibliographic record
Abstract
Background: While the pandemic of coronavirus disease-19 (COVID-19) enters a new phase and the proportion of individuals with a prior COVID-19 diagnosis grows, the national trend in utilization and medium-term outcomes of kidney transplantation (KT) from COVID-19 positive donors remain unknown. This study evaluated the trend in utilization and KT outcomes of kidneys from donors with active or resolved COVID-19. Methods: This retrospective cohort study used Standard Analysis and Research (STAR) data from 3/1/2020 to 3/30/2023. The exposure was donor SARS-CoV-2 NAT results, i.e., positive NAT within 7 days as active COVID-19, and positive NAT 7 days before procurement as resolved COVID-19. Kidney non-utilization, graft failure, allcause death, acute rejection in six months, length of hospital stay (LOS), and delayed graft function (DGF). Multivariable logistic regression for kidney non-utilization, rejection, and DGF, multivariable linear regression for LOS, and Cox analyses for graft failure and all-cause death were performed. All models were adjusted for inverse probability treatment weighting. Results: The likelihood of non-utilization of kidneys from active or resolved COVID-19+ donors declined over time. During 2020-2022, kidneys from COVID-19+ donors had a higher risk of non-utilization compared to kidneys from donors without COVID-19. In 2023, kidneys from active or resolved COVID-19+ donors were no longer associated with higher risk of non-utilization. No higher risk of graft failure was found in KT recipients receiving active COVID-19+ kidneys (adjusted hazard ratio [aHR], 1.03; 95% CI, 0.78-1.37) or resolved COVID-19+ kidneys (aHR, 1.10; 95% CI, 0.88-1.39). Donor COVID-19 positivity was not associated with all-cause death, longer LOS, higher risk of acute rejection, neither DGF. Conclusions: This cohort study found that the non-utilization rate of kidneys from COVID-19+ donors declined over time and donor COVID-19 positivity was not associated with inferior KT outcome within 2 years post-transplantation.Table:: Non-utilization of active and resolved COVID-19 positive kidneys and transplant outcome, OPTN 2020-2023.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".