{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T22:34:08Z","timestamp":1784932448489,"version":"3.55.0"},"reference-count":19,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Delayed graft function in kidney-transplant recipients is associated with increased financial cost and patient burden. In donors with high Kidney Donor Profile Index whose kidneys are not pumped, therapeutic hypothermia has been shown to confer a protective benefit against delayed graft function.<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine whether hypothermia is superior to normothermia in preventing delayed graft function in low-risk nonpumped kidney donors after brain death.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>In a multicenter randomized clinical trial, brain-dead kidney donors deemed to be low risk and not requiring machine perfusion per Organ Procurement Organization protocol were prospectively randomized to hypothermia (34.0-35 \u00b0C) or normothermia (36.5-37.5 \u00b0C) between August 10, 2017, and May 21, 2020, across 4 Organ Procurement Organizations in the US (Arizona, Upper Midwest, Pacific Northwest, and Texas). The final analysis report is dated June 15, 2022, based on the data set received from the United Network for Organ Sharing on June 2, 2021. A total of 509 donors (normothermia: n\u2009=\u2009245 and hypothermia: n\u2009=\u2009236; 1017 kidneys) met inclusion criteria over the study period.<\/jats:p><\/jats:sec>Intervention<\/jats:title>Donor hypothermia (34.0-35.0 \u00b0C) or normothermia (36.5-37.5 \u00b0C).<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was delayed graft function in the kidney recipients, defined as the need for dialysis within the first week following kidney transplant. The primary analysis follows the intent-to-treat principle.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 934 kidneys were transplanted from 481 donors, of which 474 were randomized to the normothermia group and 460 to the hypothermia group. Donor characteristics were similar between the groups, with overall mean (SD) donor age 34.2 (11.1) years, and the mean donor creatinine level at enrollment of 1.03 (0.53) mg\/dL. There was a predominance of Standard Criteria Donors (98% in each treatment arm) with similar low mean (SD) Kidney Donor Profile Index (normothermia: 28.99 [20.46] vs hypothermia: 28.32 [21.9]). Cold ischemia time was similar in the normothermia and hypothermia groups (15.99\u2009[7.9] vs 15.45\u2009[7.63] hours). Delayed graft function developed in 87 of the recipients (18%) in the normothermia group vs 79 (17%) in the hypothermia group (adjusted odds ratio, 0.92; 95% CI, 0.64-1.33; P<\/jats:italic>\u2009=\u2009.66).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The findings of this study suggest that, in low-risk non-pumped kidneys from brain-dead kidney donors, therapeutic hypothermia compared with normothermia does not appear to prevent delayed graft function in kidney transplant recipients.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT02525510<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.53785","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T16:33:13Z","timestamp":1709137993000},"page":"e2353785","source":"Crossref","is-referenced-by-count":10,"title":["Therapeutic Hypothermia in Low-Risk Nonpumped Brain-Dead Kidney Donors"],"prefix":"10.1001","volume":"7","author":[{"given":"Madhukar S.","family":"Patel","sequence":"first","affiliation":[{"name":"Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan D.","family":"Salcedo-Betancourt","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Saunders","sequence":"additional","affiliation":[{"name":"Berry Consultants, LLC, Austin, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Broglio","sequence":"additional","affiliation":[{"name":"Oncology Statistical Innovation, AstraZeneca, Gaithersburg, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Malinoski","sequence":"additional","affiliation":[{"name":"Division of Trauma, Critical Care, and Acute Care Surgery, Oregon Health & Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus U.","family":"Niemann","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California"},{"name":"Division of Transplantation, Department of Surgery, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"issue":"10","key":"zoi231575r1","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1097\/TP.0b013e3182a19348","article-title":"Defining delayed graft function after renal transplantation: simplest is best.","volume":"96","author":"Mallon","year":"2013","journal-title":"Transplantation"},{"issue":"11","key":"zoi231575r2","doi-asserted-by":"publisher","first-page":"2967","DOI":"10.1097\/01.ASN.0000093254.31868.85","article-title":"Nomogram for predicting the likelihood of delayed graft function in adult cadaveric renal transplant recipients.","volume":"14","author":"Irish","year":"2003","journal-title":"J Am Soc Nephrol"},{"issue":"2","key":"zoi231575r3","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1159\/000491558","article-title":"Delayed graft function: the AKI of kidney transplantation.","volume":"140","author":"Mannon","year":"2018","journal-title":"Nephron"},{"issue":"3","key":"zoi231575r4","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1093\/ndt\/gfn667","article-title":"Association between delayed graft function and allograft and patient survival: a systematic review and meta-analysis.","volume":"24","author":"Yarlagadda","year":"2009","journal-title":"Nephrol Dial Transplant"},{"issue":"7","key":"zoi231575r5","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1097\/00007890-199504150-00007","article-title":"Delayed graft function, acute rejection, and outcome after cadaver renal transplantation: the multivariate analysis.","volume":"59","author":"Troppmann","year":"1995","journal-title":"Transplantation"},{"issue":"10","key":"zoi231575r6","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.v34.10","article-title":"Financial impact of delayed graft function in kidney transplantation.","volume":"34","author":"Kim","year":"2020","journal-title":"Clin Transplant"},{"issue":"2","key":"zoi231575r7","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1034\/j.1600-6143.2001.10204.x","article-title":"Delayed graft function: state of the art, November 10-11, 2000; 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