{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:05:00Z","timestamp":1792631100652,"version":"4.5.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>Donation after circulatory death (DCD) donors are an important source of kidneys for transplantation, but DCD donor transplantation is less common in the United States than in other countries. In this study of national data obtained between 2008 and 2015, recovery of DCD kidneys varied substantially among the country\u2019s 58 donor service areas, and 25% of DCD kidneys were recovered in only four donor service areas. Overall, 20% of recovered DCD kidneys were discarded, varying from 3% to 33% among donor service areas. Compared with kidneys from neurologically brain dead (NBD) donors, DCD kidneys had a higher adjusted odds ratio of discard that varied from 1.25 (95% confidence interval [95% CI], 1.16 to 1.34) in kidneys with total donor warm ischemic time (WIT) of 10\u201326 minutes to 2.67 (95% CI, 2.34 to 3.04) in kidneys with total donor WIT &gt;48 minutes. Among the 12,831 DCD kidneys transplanted, kidneys with WIT\u226448 minutes had survival similar to that of NBD kidneys. DCD kidneys with WIT&gt;48 minutes had a higher risk of allograft failure (hazard ratio, 1.23; 95% CI, 1.07 to 1.41), but this risk was limited to kidneys with cold ischemia time (CIT) &gt;12 hours. We conclude that donor service area\u2013level variation in the recovery and discard of DCD kidneys is large. Additional national data collection is needed to understand the potential to increase DCD donor transplantation in the United States. Strategies to minimize cold ischemic injury may safely allow increased use of DCD kidneys with WIT&gt;48 minutes.<\/jats:p>","DOI":"10.1681\/asn.2017030238","type":"journal-article","created":{"date-parts":[[2017,10,5]],"date-time":"2017-10-05T21:00:30Z","timestamp":1507237230000},"page":"3647-3657","source":"Crossref","is-referenced-by-count":78,"title":["Use and Outcomes of Kidneys from Donation after Circulatory Death Donors in the United States"],"prefix":"10.1681","volume":"28","author":[{"given":"John","family":"Gill","sequence":"first","affiliation":[{"name":"Division of Nephrology, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada;"},{"name":"Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caren","family":"Rose","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada;"},{"name":"Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Lesage","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yayuk","family":"Joffres","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagbir","family":"Gill","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada;"},{"name":"Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"LifeCenter Northwest, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,10,5]]},"reference":[{"key":"B2-20230819","first-page":"2893","article-title":"Categories of non-heart-beating donors.","volume":"27","author":"Kootstra","year":"1995","journal-title":"Transplant Proc"},{"key":"B3-20230819","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1681\/ASN.2015010023","article-title":"New solutions to reduce discard of kidneys donated for transplantation.","volume":"27","author":"Reese","year":"2016","journal-title":"J Am Soc Nephrol"},{"issue":"Suppl 1","key":"B4-20230819","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/01.TP.0000438215.16737.68","article-title":"Organ donation and transplantation in the UK-the last decade: A report from the UK national transplant registry.","volume":"97","author":"Johnson","year":"2014","journal-title":"Transplantation"},{"key":"B8-20230819","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1111\/tri.12056","article-title":"Agonal period in donation after cardiac death donors.","volume":"26","author":"Burcin Taner","year":"2013","journal-title":"Transpl Int"},{"key":"B12-20230819","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/j.1600-6143.2005.01194.x","article-title":"Report of a national conference on donation after cardiac death.","volume":"6","author":"Bernat","year":"2006","journal-title":"Am J Transplant"},{"key":"B13-20230819","first-page":"68","article-title":"Donation after cardiac death: The University of Wisconsin experience.","volume":"9","author":"D\u2019Alessandro","year":"2004","journal-title":"Ann Transplant"},{"key":"B20-20230819","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1056\/NEJMoa020274","article-title":"Kidney transplantation from donors without a heartbeat.","volume":"347","author":"Weber","year":"2002","journal-title":"N Engl J Med"},{"key":"B24-20230819","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.2307\/2531734","article-title":"Models for longitudinal data: A generalized estimating equation approach.","volume":"44","author":"Zeger","year":"1988","journal-title":"Biometrics"},{"key":"B25-20230819","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1002\/sim.4780132105","article-title":"Cox regression analysis of multivariate failure time data: The marginal approach.","volume":"13","author":"Lin","year":"1994","journal-title":"Stat Med"}],"container-title":["Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00001751-201712000-00024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T19:29:52Z","timestamp":1786130992000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00001751-201712000-00024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,5]]},"references-count":9,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1681\/asn.2017030238","relation":{},"ISSN":["1046-6673","1533-3450"],"issn-type":[{"value":"1046-6673","type":"print"},{"value":"1533-3450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,5]]}}}