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Data tables were generated from the OHSU transplant Datamart, which contains key data elements for each OHSU kidney transplant. Additional data elements were integrated from the UNOS's Review of Organ offers report which provides additional data about the organ donor and non-identifiable outcomes of other transplants from the same donor. The incidence of DGF was calculated; univariate and multivariate analysis were performed on recipient, donor, and other variables. Chart review was performed on cases with DGF to identify possible recipient causes.RESULTS: Between 1/1/2012-12/31/2016, 326 patients received deceased donor kidney transplants at OHSU. The overall number of DGF was 31 (9.5%). The rate of DGF decreased from 20.8% in 2012 to 2.7% in 2016. Univariate analysis revealed that male sex, donation after circulatory death (DCD), DGF in the mate kidney, increased donor age, higher KDPI, cold ischemia time, and earlier transplant year were associated with increased risk of DGF. On multivariate analysis, DCD, KDPI, DGF in the mate kidney, cold ischemia time >15hrs, pulsatile perfusion were associated with increased risk of DGF. In the 31 patients that had DGF, recipient causes such as myocardial infarction, severe perioperative hypotension, cardiac arrhythmia, simultaneous heart transplant, vascular complications, rejection, and recurrence of disease accounted for 11 of the 31 (35%) patients with DGF.CONCLUSIONS: Rates of DGF in deceased donor kidney transplant at OHSU are lower than rates that are commonly reported. This may suggest that DGF rates may be modifiable through relatively simple interventions such as use of pulsatile perfusion or protocolled procurement. Recipient factors, especially cardiovascular hemodynamic status, may be responsible for DGF in about 3% of all transplants which may be represent an additional area for research and quality improvement.

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limitation of short term assessment, this study aims to optimize decellularization methods that can preserve functional vascular architecture for long-term implantation.METHODS: We compared three different decellularization protocols (1% Triton X-100, 0.25% and 0.5% SDS) and assessed the effects of the decellularization on the maintenance of pig kidney's glomeruli and afferent artery using angiography, vascular corrosion casts, and scanning electron microscopy (SEM) analysis. Particularly, the vascular casting technique was efficiently used to analyze normal morphology and functional architecture of a vascular luminal structure.RESULTS: Angiographic images of native and decellularized kidneys using three decellularization methods show clear visualization of main renal artery, segmental and lobar arteries, indicating no structural changes after decellularization. SEM analysis of the vascular casts of the different kidneys demonstrate that native 1% Triton treated kidney retained small arteries and glomeruli structures compared with the decellularized kidneys with SDS treatment.CONCLUSIONS: Our results demonstrate that the decellularization protocol using 1% Triton X-100 was most effective in preserving microvasculatures of the renal scaffold and that the optimized method may contribute to vascular patency long-term following kidney implantation.

The aim of this study is to analyze effect and adverse event of rituximab as induction therapy in living-donor renal transplantation.METHODS: Ninety-two recipients undergoing living-donor renal transplantation in our institution from May 2009 to August 2018 were retrospectively evaluated. We excluded 4 recipients who were followed less than 3 months after renal transplantation. Indications of preoperative rituximab (200mg/body) are the following; 1. ABO major mismatch, 2. ABO minor mismatch, 3. de novo donor-specific antihuman leukocyte antigens antibodies (DSA) positive, 4. Focal segmental glomerulosclerosis (FSGS). This study was approved by Ethical Committee of Okayama University Hospital and the informed consent of the patients.RESULTS: There were 68 in rituximab group (Rit), and 20 in non-rituximab group (non-Rit). Median follow-up was 40 months. There were significant differences between two groups in age (median; 32 vs 47, p[0.01), but were no significant differences in sex (male: 68% vs 65% p[0.83), FSGS (0% vs 4%, p[0.35) or primary cytomegalovirus (CMV) infection (30% vs 15%, p[0.15). Serum creatinine did not demonstrate significant differences between two groups except 3 months after transplantation (median; 1.4 mL/min in Rit group vs 1.1 mL/min in non-Rit group, p[0.02). Acute injection (5% vs 7%, p[0.72), the use of G-CSF (25% vs 34%, p[0.54), CMV infection (26% vs 13%, p[0.15) and graft loss (11% vs 8%, p[0.15) demonstrated no significant differences between two groups.CONCLUSIONS: Rituximab induction therapy is effective in immunological high risk recipients. It does not increase adverse event.