It is the time to rethink the criteria to define transplantable kidneys. Should we combine histological and clinical evaluation?

In this issue of Transplant International, Sanchez‐Escudero et al. 1 report the results obtained from a prospective single‐centre study enrolling 485 consecutive transplant recipients receiving a kidney with a Remuzzi score (RS) 2 of pretransplant donor biopsies (PTDB) lower or equal to 4. Then retrospectively, the authors compared their organ allocation policy based on RS with kidney donor profile index (KDPI) 3 and evaluated the discard rate between KDPI and PTDB and five‐year graft and patients survival. Their data support the hypothesis that PTDB could support the acceptance of kidneys with the highest KDPI.