{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T18:28:36Z","timestamp":1749061716198},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>Expanded criteria donor (ECD) kidneys are associated with higher graft loss rates than standard criteria donor kidneys. We sought to determine factors associated with early graft loss and their discrimination ability for this outcome compared with kidney donor risk index.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>Data were extracted from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) for ECD transplants between 1997 and 2014. The primary outcome was early graft loss (all-cause graft loss within 3 y of transplantation). Death-censored graft loss was substituted as a sensitivity analysis. Era-adjusted odds ratios were calculated by multivariable logistic regression for donor, recipient, and transplant factors available at transplantation. Discrimination was assessed by c-statistic, with 95% confidence intervals (CIs) calculated by bootstrapping.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>Of 2152 ECD kidney transplants, early graft loss occurred in 406 (19%) and was associated with recipient diabetes, smoking, First Nations recipients, and oliguria. Of factors defining ECD (age, elevated terminal creatinine, hypertension, death from cerebrovascular accident), all but mode of death were associated with early graft loss. The multivariable model, including known donor, recipient, and transplant factors, was moderately good at predicting early graft loss (c-statistic 0.65; 95% CI, 0.62-0.68). Recipient factors (c-statistic 0.62; 95% CI, 0.59-0.65) performed equally well compared with donor factors (c-statistic 0.60; 95% CI, 0.57-0.64) or the kidney donor risk index (c-statistic 0.60; 95% CI, 0.56-0.63).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions.<\/jats:title>\n            <jats:p>Early graft loss occurs in approximately one-fifth of ECD kidney transplants. The discriminatory value of commonly used recipient, donor, and transplant factors are approximately comparable and limited.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/txd.0000000000001235","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T22:48:45Z","timestamp":1634942925000},"page":"e783","update-policy":"http:\/\/dx.doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Early Graft Loss Following Transplantation From Expanded Criteria Donors"],"prefix":"10.1097","volume":"7","author":[{"given":"Nicholas G.","family":"Larkins","sequence":"first","affiliation":[{"name":"Department of Nephrology and Hypertension, Perth Children\u2019s Hospital, Nedlands, WA, Australia."},{"name":"School of Medicine, University of Western Australia, Perth, Australia."}]},{"given":"Germaine","family":"Wong","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, Children\u2019s Hospital at Westmead, Westmead, NSW, Australia."},{"name":"School of Public Health, University of Sydney, Birsbane, QLD, Australia."},{"name":"Department of Nephrology, Westmead Hospital, Westmead, Australia."}]},{"given":"David W.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia."}]},{"given":"Carmel","family":"Hawley","sequence":"additional","affiliation":[{"name":"Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia."}]},{"given":"Armando","family":"Teixeira-Pinto","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, Children\u2019s Hospital at Westmead, Westmead, NSW, Australia."},{"name":"School of Public Health, University of Sydney, Birsbane, QLD, Australia."}]},{"given":"Henry","family":"Pleass","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney Medical School, Sydney, Australia."}]},{"given":"Helen","family":"Pilmore","sequence":"additional","affiliation":[{"name":"Renal Unit, Auckland Hospital, Auckland, New Zealand."},{"name":"Department of Medicine, Auckland University, Auckland, New Zealand."}]},{"given":"Wai H.","family":"Lim","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Western Australia, Perth, Australia."},{"name":"Department of Nephrology, Sir Charles Gardiner Hospital, Nedlands, WA, Australia."}]}],"member":"276","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"R2-20240805","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1681\/ASN.V123589","article-title":"Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates.","volume":"12","author":"Ojo","year":"2001","journal-title":"J Am Soc Nephrol"},{"key":"R3-20240805","doi-asserted-by":"crossref","first-page":"2812","DOI":"10.1097\/TP.0000000000001850","article-title":"Taking kidneys for granted? Time to reflect on the choices we make.","volume":"101","author":"Wong","year":"2017","journal-title":"Transplantation"},{"issue":"suppl 4","key":"R4-20240805","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1034\/j.1600-6143.3.s4.11.x","article-title":"Expanded criteria donors for kidney transplantation.","volume":"3","author":"Metzger","year":"2003","journal-title":"Am J Transplant"},{"key":"R5-20240805","doi-asserted-by":"crossref","first-page":"128","DOI":"10.2215\/CJN.03760415","article-title":"Mortality among younger and older recipients of kidney transplants from expanded criteria donors compared with standard criteria donors.","volume":"11","author":"Ma","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"key":"R6-20240805","doi-asserted-by":"crossref","first-page":"h3557","DOI":"10.1136\/bmj.h3557","article-title":"Long term outcomes of transplantation using kidneys from expanded criteria donors: prospective, population based cohort study.","volume":"351","author":"Aubert","year":"2015","journal-title":"BMJ"},{"key":"R7-20240805","doi-asserted-by":"crossref","first-page":"2726","DOI":"10.1001\/jama.294.21.2726","article-title":"Deceased-donor characteristics and the survival benefit of kidney transplantation.","volume":"294","author":"Merion","year":"2005","journal-title":"JAMA"},{"key":"R8-20240805","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/TP.0b013e3181ac620b","article-title":"A comprehensive risk quantification score for deceased donor kidneys: the kidney donor risk index.","volume":"88","author":"Rao","year":"2009","journal-title":"Transplantation"},{"key":"R9-20240805","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1093\/ndt\/gfz090","article-title":"External validation of the US and UK kidney donor risk indices for deceased donor kidney transplant survival in the Australian and New Zealand population.","volume":"34","author":"Clayton","year":"2019","journal-title":"Nephrol Dial Transplant"},{"key":"R10-20240805","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1111\/tri.12736","article-title":"Comparison of survival outcomes between Expanded Criteria Donor and Standard Criteria Donor kidney transplant recipients: a systematic review and meta-analysis.","volume":"29","author":"Querard","year":"2016","journal-title":"Transpl Int"},{"key":"R11-20240805","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/kisup.2015.8","article-title":"Australia and New Zealand Dialysis and Transplant Registry.","volume":"5","author":"McDonald","year":"2015","journal-title":"Kidney Int Suppl (2011)"},{"key":"R12-20240805","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","article-title":"Establishing a standard definition for child overweight and obesity worldwide: international survey.","volume":"320","author":"Cole","year":"2000","journal-title":"BMJ"},{"key":"R13-20240805","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1093\/ndt\/gfs287","article-title":"Comparison of the long-term outcomes of kidney transplantation: USA versus Spain.","volume":"28","author":"Ojo","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"R14-20240805","doi-asserted-by":"crossref","first-page":"e345","DOI":"10.1097\/TP.0000000000001911","article-title":"Organ transplantation in Australia: inequities in access and outcome for Indigenous Australians.","volume":"101","author":"Lawton","year":"2017","journal-title":"Transplantation"},{"key":"R15-20240805","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1097\/TP.0000000000002891","article-title":"Allograft and patient outcomes between indigenous and nonindigenous kidney transplant recipients.","volume":"104","author":"Howson","year":"2020","journal-title":"Transplantation"},{"key":"R17-20240805","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1111\/ajt.13162","article-title":"Early graft loss after kidney transplantation: risk factors and consequences.","volume":"15","author":"Hamed","year":"2015","journal-title":"Am J Transplant"},{"key":"R18-20240805","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1001\/jamasurg.2021.0949","article-title":"Oxygenated end-hypothermic machine perfusion in expanded criteria donor kidney transplant: a randomized clinical trial.","volume":"156","author":"Husen","year":"2021","journal-title":"JAMA Surg"},{"key":"R19-20240805","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1093\/ndt\/gfy010","article-title":"Machine perfusion and long-term kidney transplant recipient outcomes across allograft risk strata.","volume":"33","author":"Sandal","year":"2018","journal-title":"Nephrol Dial Transplant"},{"key":"R20-20240805","first-page":"CD011671","article-title":"Machine perfusion preservation versus static cold storage for deceased donor kidney transplantation.","volume":"3","author":"Tingle","year":"2019","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Transplantation Direct"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/TXD.0000000000001235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T05:06:06Z","timestamp":1722834366000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/TXD.0000000000001235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,22]]},"references-count":18,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/txd.0000000000001235","relation":{},"ISSN":["2373-8731"],"issn-type":[{"type":"electronic","value":"2373-8731"}],"subject":[],"published":{"date-parts":[[2021,10,22]]}}}