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dc.contributor.authorZaphiros, Nikolas Hen_US
dc.contributor.authorNie, Jingen_US
dc.contributor.authorAlchaer, Michael Wen_US
dc.contributor.authorKayler, Liise Ken_US
dc.description.abstractDonation 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.en_US
dc.publisherWiley Online Libraryen_US
dc.subjectCold ischemia timeen_US
dc.subjectDelayed graft functionen_US
dc.subjectDonation after circulatory deathen_US
dc.subjectGraft survivalen_US
dc.subjectKidney transplanten_US
dc.titleOutcomes of DCD kidneys with CIT-induced delayed graft functionen_US
dc.typeJournal Articleen_US
dc.contributor.affiliationFaculty of Medicineen_US
dc.description.statusIn Pressen_US
dc.relation.ispartoftextClinical Transplantationen_US
Appears in Collections:Faculty of Medicine
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