{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T22:53:00Z","timestamp":1753051980790,"version":"3.37.3"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP 1147657","APP 1195414"],"award-info":[{"award-number":["APP 1147657","APP 1195414"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Kidneys donated after circulatory death suffer a period of functional warm ischaemia before death, which may lead to early ischaemic injury. Effects of haemodynamic trajectories during the agonal phase on delayed graft function (DGF) is unknown. We aimed to predict the risk of DGF using patterns of trajectories of systolic blood pressure (SBP) declines in Maastricht category 3 kidney donors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a cohort study of all kidney transplant recipients in Australia who received kidneys from donation after circulatory death donors, divided into a derivation cohort (transplants between 9 April 2014 and 2 January 2018 [462 donors]) and a validation cohort (transplants between 6 January 2018 and 24 December 2019 [324 donors]). Patterns of SBP decline using latent class models were evaluated against the odds of DGF using a two-stage linear mixed effects model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the derivation cohort, 462 donors were included in the latent class analyses and 379 donors in the mixed effects model. Of the 696 eligible transplant recipients, 380 (54.6%) experienced DGF. Ten different trajectories, with distinct patterns of SBP decline were identified. Compared with recipients from donors with the slowest decline in SBP after withdrawal of cardiorespiratory support, the adjusted odds ratio (aOR) for DGF was 5.5 [95% confidence interval (CI) 1.38\u201328.0] for recipients from donors with a steeper decline and lowest SBP [mean 49.5\u00a0mmHg (standard deviation 12.5)] at the time of withdrawal. For every 1\u00a0mmHg\/min reduction in the rate of decline of SBP, the respective aORs for DGF were 0.95 (95% CI 0.91\u20130.99) and 0.98 (95% CI 0.93\u20131.0) in the random forest and least absolute shrinkage and selection operator models. In the validation cohort, the respective aORs were 0.95 (95% CI 0.91\u20131.0) and 0.99 (95% CI 0.94\u20131.0).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Trajectories of SBP decline and their determinants are predictive of DGF. These results support a trajectory-based assessment of haemodynamic changes in donors after circulatory death during the agonal phase for donor suitability and post-transplant outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfad047","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T01:13:25Z","timestamp":1678929205000},"page":"1170-1179","source":"Crossref","is-referenced-by-count":3,"title":["Trajectories of systolic blood pressure decline in kidney transplant donors prior to circulatory death and delayed graft function"],"prefix":"10.1093","volume":"16","author":[{"given":"Yingxin","family":"Lin","sequence":"first","affiliation":[{"name":"Sydney School of Public Health, University of Sydney , Sydney, NSW, Australia"},{"name":"Faculty of Science, School of Mathematics and Science, University of Sydney , Sydney, NSW, Australia"}]},{"given":"Armando","family":"Teixeira-Pinto","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, University of Sydney , Sydney, NSW, Australia"},{"name":"Centre for Kidney Research, Kids Research Institute, Children's Hospital at Westmead , Sydney, NSW, Australia"}]},{"given":"Jonathan C","family":"Craig","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health, Flinders University , Adelaide, SA, Australia"}]},{"given":"Helen","family":"Opdam","sequence":"additional","affiliation":[{"name":"Department of Surgery, DonateLife, Organ and Tissue Authority , Canberra, ACT, Australia"}]},{"given":"Jeremy C","family":"Chapman","sequence":"additional","affiliation":[{"name":"Centre for Transplant and Renal Research, Westmead Hospital , Sydney, NSW, Australia"}]},{"given":"Henry","family":"Pleass","sequence":"additional","affiliation":[{"name":"Centre for Transplant and Renal Research, Westmead Hospital , Sydney, NSW, 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Medical Research Institute , Adelaide, SA, Australia"},{"name":"Adelaide Medical School, University of Adelaide , Adelaide, SA, Australia"}]},{"given":"Jean","family":"Yang","sequence":"additional","affiliation":[{"name":"Faculty of Science, School of Mathematics and Science, University of Sydney , Sydney, NSW, Australia"}]},{"given":"Wai H","family":"Lim","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Science, University of Western Australia , Perth , WA, Australia"},{"name":"Department of Renal Medicine, Sir Charles Gairdner Hospital , Perth , WA, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8422-7269","authenticated-orcid":false,"given":"Germaine","family":"Wong","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, University of Sydney , Sydney, NSW, Australia"},{"name":"Centre for Kidney Research, Kids Research Institute, Children's Hospital at Westmead , Sydney, NSW, Australia"},{"name":"Centre for Transplant and 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