{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T19:44:40Z","timestamp":1787946280676,"version":"build-2784847793"},"reference-count":29,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T00:00:00Z","timestamp":1649980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009033","name":"NHS Blood and Transplant","doi-asserted-by":"publisher","award":["WP 15 03"],"award-info":[{"award-number":["WP 15 03"]}],"id":[{"id":"10.13039\/100009033","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In kidney transplantation, the relative contribution of various donor, procedure and recipient-related factors on clinical outcomes is unknown. Previous paired studies have largely focused on examining factors predicting early outcomes, where the effect of donor factors is thought to be most important. Here, we sought to examine the relationship between early and long-term outcomes in a UK-wide paired kidney analysis. Methods: UK Transplant Registry data covering 24,090 kidney transplants performed between 2001\u20132018, where both kidneys from each donor were transplanted, were analysed. Case-control studies were constructed using matched pairs of kidneys from the same donor discordant for outcome, to delineate the impact of transplant and recipient factors on longer-term outcomes. Results: Multivariable conditional logistic regression identified HLA mismatch as an important predictor of prolonged delayed graft function (DGF), in the context of a paired study controlling for the influence of donor factors, even when adjusting for early acute rejection. Prolonged DGF, but not human leucocyte antigen (HLA) mismatch, strongly predicted 12-month graft function, and impaired 12-month graft function was associated with an increased risk of graft failure. Conclusions: This study indicates prolonged DGF is associated with adverse long-term outcomes and suggests that alloimmunity may contribute to prolonged DGF by a mechanism distinct from typical early acute rejection.<\/jats:p>","DOI":"10.3390\/jcm11082222","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T04:21:28Z","timestamp":1650255688000},"page":"2222","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Transplant and Recipient Factors in Prediction of Kidney Transplant Outcomes: A UK-Wide Paired Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Richard","family":"Dumbill","sequence":"first","affiliation":[{"name":"Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 9DU, UK"},{"name":"Oxford Transplant Unit, Oxford University Hospitals, Oxford OX3 7LE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roderick","family":"Jaques","sequence":"additional","affiliation":[{"name":"Statistics and Clinical Studies, NHS Blood and Transplant, Bristol BS34 7QH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Robb","sequence":"additional","affiliation":[{"name":"Statistics and Clinical Studies, NHS Blood and Transplant, Bristol BS34 7QH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Johnson","sequence":"additional","affiliation":[{"name":"Statistics and Clinical Studies, NHS Blood and Transplant, Bristol BS34 7QH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rutger J.","family":"Ploeg","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 9DU, UK"},{"name":"Research and Development, NHS Blood and Transplant, Oxford OX3 9DU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Kaisar","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 9DU, UK"},{"name":"Research and Development, NHS Blood and Transplant, Oxford OX3 9DU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Sharples","sequence":"additional","affiliation":[{"name":"Oxford Transplant Unit, Oxford University Hospitals, Oxford OX3 7LE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1093\/ndt\/gfl042","article-title":"Major effects of delayed graft function and cold ischaemia time on renal allograft survival","volume":"21","author":"Quiroga","year":"2006","journal-title":"Nephrol. 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