{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:02Z","timestamp":1787028662156,"version":"build-2736575974"},"reference-count":27,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Uncontrolled donation after circulatory death (uDCD) remains underutilized globally, despite critical organ shortages. We report outcomes from Israel\u2019s uDCD kidney transplant program compared with the matched donation after brain death (DBD) recipients. Methods: This retrospective cohort study analyzed all uDCD kidney transplants performed at the Rabin Medical Center between January 2018 and December 2024, compared with DBD transplants during the same period. Propensity score matching (1:3 ratio) was performed using recipient demographics, comorbidities, and donor characteristics. Primary outcomes included delayed graft function (DGF), graft failure, and patient survival. Results: Among 92 kidney transplants, 21 (22.8%) were from uDCD donors. After propensity-matching (21 uDCD, 63 DBD), significant baseline differences persisted: uDCD recipients were younger (47.2 \u00b1 11.8 vs. 57.5 \u00b1 10.9 years, p &lt; 0.001) despite a similar dialysis vintage (7.2 \u00b1 3.2 vs. 7.7 \u00b1 3.7 years, p = 0.569). Warm ischemia time was 58.5 \u00b1 12.3 vs. 3.0 \u00b1 0.0 min (p &lt; 0.001), and cold ischemia time was longer in uDCD (13.7 \u00b1 5.9 vs. 8.4 \u00b1 2.5 h, p &lt; 0.001). DGF occurred in 90.5% of uDCD versus 54.1% of DBD recipients (p = 0.006). Graft failure was markedly higher in uDCD (28.6% vs. 1.6%, p = 0.001), yet mortality was lower (14.3% vs. 27.9%, p = 0.339). After a median follow-up of 60 months (IQR 48\u201372) for both groups, the death-censored 5 year graft survival rate was 71.4% for uDCD versus 98.4% for DBD (p &lt; 0.001). Conclusions: Despite higher rates of DGF and graft failure, uDCD kidney transplantation demonstrated an acceptable 5 year patient survival rate in carefully selected younger recipients. These findings support cautious expansion of uDCD programs with rigorous recipient selection criteria and realistic outcome expectations.<\/jats:p>","DOI":"10.3390\/jcm14228068","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T16:46:22Z","timestamp":1763138782000},"page":"8068","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Uncontrolled Donation After Circulatory Death Kidney Transplantation: A Single-Center Experience in Israel with Propensity-Matched Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9754-5028","authenticated-orcid":false,"given":"Fahim","family":"Kanani","sequence":"first","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Center, Gray Faculty of Medicine, Tel Aviv University, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Ben Avraham","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Center, Gray Faculty of Medicine, Tel Aviv University, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-7921","authenticated-orcid":false,"given":"Vladimir","family":"Tennak","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Center, Gray Faculty of Medicine, Tel Aviv University, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wadim","family":"Mezebovsky","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Center, Gray Faculty of Medicine, Tel Aviv University, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gurevich","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Center, Gray Faculty of Medicine, Tel Aviv University, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigal","family":"Eisner","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Center, Gray Faculty of Medicine, Tel Aviv University, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aviad","family":"Gravetz","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Center, Gray Faculty of Medicine, Tel Aviv University, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eviatar","family":"Nesher","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Center, Gray Faculty of Medicine, Tel Aviv University, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"106021","DOI":"10.1016\/j.ijsu.2021.106021","article-title":"Implementation of donation after circulatory death kidney transplantation can safely enlarge the donor pool: A systematic review and meta-analysis","volume":"92","author":"Rijkse","year":"2021","journal-title":"Int. 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