The iBox (Integrative Box) risk prediction score, integrating functional, immunological, and histological factors, offers a novel method for predicting the risk of death-censored graft failure (DCGF) in kidney transplant recipients.1 Following regulatory approval, iBox has the potential for broad clinical and research application as a surrogate endpoint.2 However, clarifying validated applications and implementation considerations is essential.3 To assess iBox’s utility in predicting DCGF in trials and real-world settings, we systematically identified, appraised, and summarized the available literature.