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Record W4411663606 · doi:10.3389/ti.2025.14596

Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline

2025· article· en· W4411663606 on OpenAlexafffund
Joanna C. Dionne, Patricia Campbell, Héloïse Cardinal, Tatiana Giannidis, Aviva Goldberg, Soojin Kim, Greg Knoll, M Pâquet, Christina Parsons, Yuhong Yuan, Rahul Mainra

Bibliographic record

VenueTransplant International · 2025
Typearticle
Languageen
FieldMedicine
TopicOrgan Donation and Transplantation
Canadian institutionsUniversity of TorontoUniversity Health NetworkOttawa HospitalUniversity of ManitobaCanadian Blood ServicesChildren's Hospital Research Institute of ManitobaUniversity of SaskatchewanUniversity of AlbertaMcMaster UniversityCentre Hospitalier de l’Université de MontréalImpact
FundersCanadian Blood Services
KeywordsMedicineGuidelineKidney transplantationDialysisTransplantationIntensive care medicineClinical PracticeKidneyNephrologyInternal medicineFamily medicinePathology

Abstract

fetched live from OpenAlex

Underutilization of deceased donor organs has worsened the gap in the number of kidneys available for transplantation. The purpose of this clinical practice guideline is to provide recommendations on the utilization of donor kidneys at risk of discard. Six conditional recommendations were made all with very low certainty of evidence: 1) We suggest utilizing extended criteria donor (ECD) kidneys for transplantation rather than remaining on the wait list and continuing with dialysis; 2) We suggest utilizing kidneys from ECD versus non-ECD in selected transplant candidates; 3) We suggest that organs from older kidney donors can be used in selected transplant candidates who may derive benefit from them; 4) We suggest that kidneys from deceased donors with acute kidney injury can be used for transplantation based on clinician assessment and donor factors; 5) We suggest that donor kidneys with acute kidney injury from either ECD or non-ECD be used for kidney transplantation; 6) We suggest using kidneys from donors after death determination by circulatory criteria for transplantation. This clinical practice guideline provides evidence for the use of deceased donor kidneys that are at risk of discard and may improve the shared decision-making between transplant physicians and wait-listed patients.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.396
Threshold uncertainty score0.307

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.045
GPT teacher head0.368
Teacher spread0.323 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations2
Published2025
Admission routes2
Has abstractyes

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