{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:34:10Z","timestamp":1790660050926,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The association between prolonged cold ischemia times (CIT), donor age, and outcomes in kidney transplant recipients (KTRs) from donors after circulatory death (DCD) remains uncertain. We aimed to compare allograft outcomes in DCD\u2010donor KTRs according to CIT and age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>UNOS database study (2010\u20132024) of DCD\u2010donor KTRs on tacrolimus maintenance. We developed a mate\u2010kidney analysis, comparing outcomes where one mate kidney had CIT &gt;24 and the other \u226424\u00a0h. We evaluated patient death, all\u2010cause allograft failure, and death\u2010censored graft failure (DCGF) using multivariable stratified Cox proportional hazards models. We compared outcomes across age groups (\u226550 or &lt;50 years) and 6\u2010h\u2010period CIT deltas between mate kidneys. We assessed delayed graft function (DGF) occurrence with multivariable conditional logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 4092 DCD\u2010donor mate\u2010kidney pairs. There were no differences between CIT &gt;24 versus \u226424\u00a0h in patient death (aHR 1.12, 95% CI 0.97\u20131.30), all\u2010cause allograft failure (aHR 1.10, 95% CI 0.98\u20131.24), or DCGF (aHR 1.07, 95% CI 0.90\u20131.27). Similar results were observed when comparing outcomes by age group and 6\u2010h\u2010period CIT deltas between mate kidneys. Compared to shorter CITs, CITs &gt;24\u00a0h were associated with increased DGF likelihood (aOR 1.42, 95% CI 1.25\u20131.60), as were increasing CIT deltas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CITs &gt;24\u00a0h in DCD\u2010donor KTRs were not associated with adverse allograft outcomes, irrespective of age group. However, prolonged CITs were associated with increased DGF likelihood. Increasing the acceptance of both mate kidney from DCD donors should be considered despite projected CITs &gt;24\u00a0h.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70051","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T17:49:09Z","timestamp":1733420949000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Cold Ischemia Time and Donor Age on Donation After Circulatory Death Kidney Transplant Outcomes: A UNOS Mate\u2010Kidney Analysis"],"prefix":"10.1111","volume":"38","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":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4126-743X","authenticated-orcid":false,"given":"Belen","family":"Rivera","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Department of Surgery Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4706-862X","authenticated-orcid":false,"given":"Stalin","family":"Ca\u00f1izares","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Department of Surgery Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1032-0801","authenticated-orcid":false,"given":"Martha","family":"Pavlakis","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2621-1431","authenticated-orcid":false,"given":"Devin","family":"Eckhoff","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Department of Surgery Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Organ Procurement and Transplantation Network National Data accessed August 21 2024.https:\/\/optn.transplant.hrsa.gov\/data\/view\u2010data\u2010reports\/national\u2010data\/."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2022.12.005"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000124296.46712.67"},{"key":"e_1_2_11_5_1","unstructured":"K. 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