{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T01:19:57Z","timestamp":1775783997328,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T00:00:00Z","timestamp":1535673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005754","name":"Sahlgrenska Universitetssjukhuset","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005754","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The state of the evidence is unclear regarding the impact of cold ischemia time (<jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content>) on the outcome of kidney transplantation. The aim of this study was to investigate the effect of <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content> on the short\u2010 and long\u2010term function of kidneys transplanted at the Sahlgrenska University Hospital in 2007\u20102009 from donors after brain death (<jats:styled-content style=\"fixed-case\">DBD<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was designed as a retrospective analysis of data from local and national transplantation registers. The study endpoints were as follows: delayed graft function (<jats:styled-content style=\"fixed-case\">DGF<\/jats:styled-content>), primary nonfunction (<jats:styled-content style=\"fixed-case\">PNF<\/jats:styled-content>), biopsy\u2010proven acute rejection (<jats:styled-content style=\"fixed-case\">BPAR<\/jats:styled-content>), serum creatinine (S\u2010creatinine) level at discharge, days of hospitalization after transplantation, and graft survival at 5\u00a0years post\u2010transplantation. Adjusted regression analyses were used to determine causal relationships with <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content>. A further aim was to estimate a threshold for <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content> by analyzing event rates and coordinates of the receiver\u2010operated characteristic (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) curve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a causal relationship between <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content> as a continuous variable and the following endpoints: graft survival at 5\u00a0years post\u2010transplantation, though this was not significant (hazard ratio (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>) 1.07, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.057), <jats:styled-content style=\"fixed-case\">DGF<\/jats:styled-content> (odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 1.09, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03) and S\u2010creatinine (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). In our material, the risk for impaired outcome was higher with longer <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content>. We were therefore able to estimate a threshold value for <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content>, set to 14\u00a0hours for both graft survival at 5\u00a0years post\u2010transplantation and <jats:styled-content style=\"fixed-case\">DGF<\/jats:styled-content>. This was proved with significance by analyzing both event rates and the coordinates of the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curve. The risk of graft loss increased, with <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 2.3 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.023), when comparing a <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content> cutoff of \u226514\u00a0hours with <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content>\u00a0&lt;\u00a014\u00a0hours. Delayed graft function increased, with an <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> of 2.6 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study confirms that, in this patient material, longer <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content> was associated with increased risk for both impaired graft survival and incidence of <jats:styled-content style=\"fixed-case\">DGF<\/jats:styled-content>. We estimated a threshold for <jats:styled-content style=\"fixed-case\">CIT<\/jats:styled-content> of 14\u00a0hours.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13377","type":"journal-article","created":{"date-parts":[[2018,8,11]],"date-time":"2018-08-11T07:00:08Z","timestamp":1533970808000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The risk of graft loss 5\u00a0years after kidney transplantation is increased if cold ischemia time exceeds 14\u00a0hours"],"prefix":"10.1111","volume":"32","author":[{"given":"Josefin","family":"Hansson","sequence":"first","affiliation":[{"name":"Transplant Institute Sahlgrenska Academy at the University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Mj\u00f6rnstedt","sequence":"additional","affiliation":[{"name":"Transplant Institute Sahlgrenska Academy at the University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8672-6811","authenticated-orcid":false,"given":"Per","family":"Lindn\u00e9r","sequence":"additional","affiliation":[{"name":"Transplant Institute Sahlgrenska Academy at the University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8,31]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"\u2018Svenskt njurregister\u2019 (Swedish Renal Registry).\u2018Njurtransplantationer uppf\u00f6ljning recipienter G\u00f6teborg 2007\u20102014\u2019 (Kidneytransplantations Recipients Follow Up Gothenburg 2007\u20102014) edition2014."},{"key":"e_1_2_8_3_1","unstructured":"Croon Ann\u2010Christine. \u2018Transplantationsregister 1964 till 2014\u2019 (Transplantation Registry 1964\u20102014) edition2014 \u2018Svensk transplantationsf\u00f6rening\u2019 (Swedish Transplantation Society)."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.12659\/AOT.896672"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(98)70073-3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl042"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2011.01510.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14597"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.09.109"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0012.2000.140302.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0b013e32835e2a08"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61685-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318169c29e"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03817.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.304"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000081042.67285.91"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012062"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fctr.13377","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.13377","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T07:31:41Z","timestamp":1694331101000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.13377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,31]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1111\/ctr.13377"],"URL":"https:\/\/doi.org\/10.1111\/ctr.13377","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,31]]},"assertion":[{"value":"2018-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13377"}}