{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:22:58Z","timestamp":1787743378866,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney transplantation confers prolonged and improved quality of life versus dialysis for patients with end\u2010stage kidney disease (ESKD). Delayed graft function (DGF) increases the risk of allograft rejection and decreases allograft survival. In adults, prolonged warm (WIT) and cold ischemia time (CIT) increase risk of DGF, and machine perfusion (MP) during organ transportation reduces this risk. However, there is a paucity of data regarding risk factors for DGF in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated risk and protective factors for DGF in patients aged 18\u2009months to 21\u2009years who underwent kidney transplantation at Cincinnati Children's Hospital Medical Center between 11\/1\/2017 and 11\/30\/2021. DGF was defined as receiving dialysis within 7\u2009days post\u2010transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine of 89 (10%) patients developed DGF. Patients with DGF had longer median WIT (49 IQR: 44\u201357 vs. 37\u2009min IQR: 30\u201343;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and were more likely to have received a deceased donor (DD) allograft (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04, RR1.7 (95% CI: 1.2\u20132.4)). There was no difference in CIT between those who did and did not experience DGF (464 IQR:329\u2013788 vs. 271\u2009min. IQR:271\u2013788;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.16). No patients who received DD\u2010MP kidneys developed DGF. DGF in recipients of DD\u2010non\u2010MP kidneys had longer WIT (53 IQR: 43\u201357 vs. 36\u2009min. IQR: 30\u201344;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increased WIT increases the risk of DGF in pediatric kidney transplant recipients, whereas MP appears to be protective against DGF and may ameliorate the adverse effect of CIT. DGF was rare in the cohort and further studies are necessary due to the low incidence of DGF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70429","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T06:40:42Z","timestamp":1786430442000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Machine Perfusion and Mitigating Risk Factors for Delayed Graft Function in Pediatric Kidney Transplant Recipients"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8238-7939","authenticated-orcid":false,"given":"Kyle A.","family":"Merrill","sequence":"first","affiliation":[{"name":"Division of Nephrology, Dialysis and Transplantation University of Iowa Stead Family Children's Hospital  Iowa City Iowa USA"},{"name":"Stead Family Department of Pediatrics University of Iowa Carver College of Medicine  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassie","family":"Kirby","sequence":"additional","affiliation":[{"name":"Center for Acute Care Nephrology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Ambrosino","sequence":"additional","affiliation":[{"name":"Transplant Administration Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0409-3799","authenticated-orcid":false,"suffix":"Jr","given":"Charles D.","family":"Varnell","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"James M. Anderson Center for Health Systems Excellence Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9802-5948","authenticated-orcid":false,"given":"Alexander","family":"Bondoc","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Surgery University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5987-8318","authenticated-orcid":false,"given":"Lakhmir","family":"Chawla","sequence":"additional","affiliation":[{"name":"Veterans Affairs San Diego Healthcare System  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3711-8785","authenticated-orcid":false,"given":"Stuart L.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Center for Acute Care Nephrology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Division of Nephrology and Hypertension Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8732-4291","authenticated-orcid":false,"given":"David K.","family":"Hooper","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"James M. 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