{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:54:49Z","timestamp":1775868889584,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T00:00:00Z","timestamp":1593129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000291","name":"Kidney Research UK","doi-asserted-by":"publisher","award":["to SH"],"award-info":[{"award-number":["to SH"]}],"id":[{"id":"10.13039\/501100000291","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Kidneys from donation after circulatory death (DCD) are more likely to be declined for transplantation compared with kidneys from donation after brain death (DBD). The aim of this study was to evaluate characteristics in the biopsies of human DCD and DBD kidneys that were declined for transplantation in order to rescue more DCD kidneys. Materials and Methods: Sixty kidney donors (DCD = 36, DBD = 24) were recruited into the study and assessed using donor demographics. Kidney biopsies taken post cold storage were also evaluated for histological damage, inflammation (myeloperoxidase, MPO), von Willebrand factor (vWF) expression, complement 4d (C4d) deposition and complement 3 (C3) activation using H&amp;E and immunohistochemistry staining, and Western blotting. Results: More DBD donors (16\/24) had a history of hypertension compared with DCDs (8\/36, p = 0.001). The mean warm ischemic time in the DCD kidneys was 12.9 \u00b1 3.9 min. The mean cold ischemic time was not significantly different between the two groups of kidney donors (DBD 33.3 \u00b1 16.7 vs. DCD 28.6 \u00b1 14.1 h, p &gt; 0.05). The score of histological damage and MPO, as well as the reactivity of vWF, C4d and C3, varied between kidneys, but there was no significant difference between the two donor types (p &gt; 0.05). However, vWF reactivity might be an early indicator for loss of tissue integrity, while C4d deposition and activated C3 might be better predictors for histological damage. Conclusions: Similar characteristics of DCD were shown in comparison with DBD kidneys. Importantly, the additional warm ischemic time in DCD appeared to have no further detectable adverse effects on tissue injury, inflammation and complement activation. vWF, C4d and C3 might be potential biomarkers facilitating the evaluation of donor kidneys.<\/jats:p>","DOI":"10.3390\/medicina56060317","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T03:40:07Z","timestamp":1593402007000},"page":"317","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Analysis of Risk Factors in Declined Kidneys from Donation after Brain Death and Circulatory Death"],"prefix":"10.3390","volume":"56","author":[{"given":"Zinah","family":"Zwaini","sequence":"first","affiliation":[{"name":"Department of Infection, Immunity and Inflammation, University of Leicester, University Road, Leicester LE1 7RH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meeta","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Infection, Immunity and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0125-4868","authenticated-orcid":false,"given":"Cordula","family":"Stover","sequence":"additional","affiliation":[{"name":"Department of Infection, Immunity and Inflammation, University of Leicester, University Road, Leicester LE1 7RH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7615-6149","authenticated-orcid":false,"given":"John","family":"Dormer","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Leicester, University Road, Leicester LE1 7RH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael L.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cambridge, Addenbrooke\u2019s Hospital, Cambridge CB2 0QQ, UK"},{"name":"Department of Cardiovascular Sciences, University of Leicester, University Hospitals of Leicester, Leicester LE1 7RH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah A.","family":"Hosgood","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cambridge, Addenbrooke\u2019s Hospital, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5315-9240","authenticated-orcid":false,"given":"Bin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester, University Hospitals of Leicester, Leicester LE1 7RH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,26]]},"reference":[{"key":"ref_1","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":"ref_2","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/ctr.12319","article-title":"The discard of deceased donor kidneys in the UK","volume":"28","author":"Callaghan","year":"2014","journal-title":"Clin. 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Transpl."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/6\/317\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:43:21Z","timestamp":1760175801000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/6\/317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,26]]},"references-count":37,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["medicina56060317"],"URL":"https:\/\/doi.org\/10.3390\/medicina56060317","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,26]]}}}