Please use this identifier to cite or link to this item:
Title: Outcomes of DCD kidneys with CIT-induced delayed graft function
Authors: Zaphiros, Nikolas H
Nie, Jing
Alchaer, Michael W
Kayler, Liise K
Affiliations: Faculty of Medicine 
Keywords: Cold ischemia time
Delayed graft function
Donation after circulatory death
Graft survival
Kidney transplant
Issue Date: 2023-04
Publisher: Wiley Online Library
Part of: Clinical Transplantation
Donation after circulatory death (DCD) kidneys are exposed to warm ischemia, which, coupled with cold ischemia time (CIT) exacerbates delayed graft function (DGF) and is possibly associated with worse graft survival. To analyze the risk of CIT-induced DGF on DCD kidney outcomes, we evaluated national data between 2008 and 2018 of adult kidney-only recipients of paired DCD kidneys where one kidney recipient experienced DGF and the other did not. Of 5602 paired DCD kidney recipients, multivariate analysis between recipients with higher CIT relative to lower CIT showed that increasing CIT differences had a significant dose-dependent effect on overall graft survival. The graft survival risk was minimal with CIT differences of ≥1-h (adjusted hazard ratio [aHR] 1.07, 95% CI .95- 1.20, n = 5602) and ≥5-h (aHR 1.09, 95% CI .93-1.29, n = 2710) and became significant at CIT differences of ≥10-h (aHR 1.37, 95% CI 1.05-1.78, n = 1086) and ≥15-h (aHR 1.78, 95% CI 1.15-2.77, n = 1086). Between each of the four delta-CIT levels of shorter and longer CIT, there were no statistically significant differences in the proportion of acute rejection. These results suggest that in the setting of DCD kidney transplantation (KTX), DGF, specifically mediated by prolonged CIT, impacts long-term graft outcomes.
ISSN: 09020063
DOI: 10.1111/ctr.14918
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

Show full item record

Record view(s)

checked on Nov 30, 2023

Google ScholarTM


Dimensions Altmetric

Dimensions Altmetric

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.