{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T07:34:24Z","timestamp":1777361664493,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney machine perfusion (MP) prevents delayed graft function (DGF). Whether this benefit translates into improved long\u2010term graft survival (LGS) remains uncertain. We evaluated the association between MP and LGS and its potential mediation by DGF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>UNOS analysis of adult deceased donor kidney transplant recipients (KTRs) from January 2010 to June 2019. We selected KTRs with cold ischemia time (CIT) &gt;\u200912\u2009h and on tacrolimus maintenance. We included KTRs from dual\u2010kidney donors and compared outcomes where one mate kidney received MP and the other did not. The primary endpoint was all\u2010cause graft failure (GF) analyzed using a stratified multivariable Cox proportional hazards model. We assessed the association of MP and DGF with conditional logistic regression. We evaluated the mediation effect of DGF by combining the predictor and outcome models and bootstrapping with 1000 iterations to calculate 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 2355 mate\u2010kidney pairs with 5.8\u2009years (IQR 4\u20138) median follow\u2010up. MP was associated with lower GF risk (aHR 0.86, 95% CI 0.75\u20130.98) and DGF odds (aOR 0.41, 95% CI 0.34\u20130.51) than no MP. DGF fully mediated the association between MP and GF, as the effect was no longer statistically significant after adjusting for DGF (aHR 0.89, 95% CI 0.78\u20131.03). DGF explained 76.8% of the association between MP and GF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In mate\u2010kidney pairs with discordant MP use and CIT &gt;\u200912\u2009h, MP was associated with decreased GF risk, mediated by decreased DGF likelihood. MP both mate kidneys with CIT &gt;\u200912\u2009h should be considered to potentially improve LGS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.15066","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T09:18:57Z","timestamp":1754299137000},"page":"104-111","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Kidney Machine Perfusion Is Associated With Improved Long\u2010Term Graft Survival Mediated by Reduced Delayed Graft Function: A Mate\u2010Kidney Analysis"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3463-6309","authenticated-orcid":false,"given":"Gabriel","family":"Cojuc\u2010Konigsberg","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9710-0483","authenticated-orcid":false,"given":"Bhavna","family":"Chopra","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2020.100585"},{"key":"e_1_2_10_3_1","unstructured":"Organ Procurement and Transplantation Network \u201cNational Data. OPTN Website \u201daccessed June 27 2024 https:\/\/optn.transplant.hrsa.gov\/data\/view\u2010data\u2010reports\/national\u2010data\/."},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.2322"},{"key":"e_1_2_10_5_1","unstructured":"K. R.Temple \u201cContinuous Distribution of Kidneys \u201dUpdate Summer 2024. 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