Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Trial of Mild Hypothermia and Machine Perfusion in Deceased Organ Donors for Protection Against Delayed Graft Function in Kidney Transplant Recipients
Brief Summary: To protect kidney function during the transplantation process by comparing mild hypothermia in the deceased organ donor before organs are recovered and pulsatile perfusion of the kidney after recovery and prior to transplantation.


Options:
A: Inclusion Criteria:

1. Adult recipients older than 18 years;
2. Patients diagnosed with end-stage renal diseases and volunteered to register in the Transplant and Dialysis Registry of China awaiting for deceased donor kidney transplantation;
3. First single kidney transplantation;
4. The recipients can understand the purpose and risk of deceased kidney transplantation and sign informed consent;
5. Ethics committee approved.

Exclusion Criteria:

1. Patients less than 18 years old, or more than 65 years old;
2. Patients who receive multiple organ transplants;
3. Diagnosed with malignancy or had a history of malignancy in the past 5 years;
4. non-kidney transplantation history.
B: GRAFT:

Inclusion criteria:

DCD:

* no absolute contraindications as per Italian National Transplant center (CNT)
* donor age ≤70 years
* witnessed and documented cardiac arrest
* macro-vescicular steatosis \<30% at liver biopsy
* necrosis \<5% at liver biopsy
* fibrosis \<2 as per Ishak's score at liver biopsy
* arteriolar thickening \<60% at liver biopsy
* WIT ≤160 minutes
* ALT \<1000 UI/L during NRP
* downward trend lactate during NRP

DBD:

* no absolute contraindications as per Italian National Transplant center (CNT)
* donor age \> 70 years
* macro-steatosis between 30 and 50% at liver biopsy

Exclusion criteria:

DCD:

* absolute contraindications as per Italian National Transplant center (CNT)
* donor age \>70 years
* macro-vescicular steatosis \>30% at liver biopsy
* necrosis \>5% at liver biopsy
* fibrosis \>2 as per Ishak's score at liver biopsy
* severe macroangiopathy (arteriolar thickening \>60% at liver biopsy)
* WIT \>160 minutes
* ALT \>1000 UI/L during NRP
* uptrend lactate during NRP

DBD:

* absolute contraindications as per Italian National Transplant center (CNT)
* donor age \< 70 years
* macro-steatosis between \> 50% at liver biopsy

RECIPIENTS

Inclusion criteria:

* Subject must be greater than or equal to 18 years of age.
* Subject with end-stage liver disease who is actively listed for primary liver transplantation
* Subject, or a legally authorized representative, has given informed consent to participate in the study

Exclusion criteria:

* Subject is currently listed as a UNOS status 1A.
* Subject is requiring oxygen therapy via ventilator/respiratory support.
* Subject is planned to undergo simultaneous solid organ transplant.
* Subject is pregnant at the time of transplant.
* Subject MELD score 25 or higher
* Subject receives re-transplantation of liver.
* Any medical conditions contro-indicating the use of DCD grafts at transplant surgeon/hepatologist evaluation
C: Inclusion Criteria:

* Donor

  1. Comply with the national DCD（donor after citizen death) guideline
  2. No high risk activities: such as history of drug abuse, history of intravenous drug use and risky sexual behavior
  3. No malignant melanoma, metastatic cancer, or incurable cancer; some of the early stages of cancer after a successful treatment can also be considered
  4. No active, untreated systemic bacterial, viral or fungal infection;
  5. Patients definitely identified
  6. Mechanical perfusion RI (resistance index ) \[0.18, 0.50\]

Recipient:

1. Age\> = 16 years old, male or female
2. BMI\<28
3. First Renal transplantation
4. Not in pregnancy or lactation, pregnancy test was negative, and promise not to be pregnant during treatment.
5. Before the clinical trial, Patient sign informed consent voluntarily

Exclusion Criteria:

* Donor

  1. Older than 50 years old
  2. Serum HBV (hepatitis B virus), HCV (hepatitis C virus), HIV positive
  3. Donor kidney cold storage time over 30 hours
  4. Warm ischemia time over 20 minutes
  5. Other reagents are added perfusion for regulation of donor renal function

Recipient:

1. Double organ or multi-organ transplant
2. Blood type-incompatible
3. Patients with other malignant diseases
D: Inclusion Criteria:

* \> 18 years of age,
* Brain dead organ donor,
* Authorization for research

Exclusion Criteria:

* Donation after Cardiac Death (DCD) Donor
* Coagulopathy, Hemodynamic instability, Electrolyte deficiencies, Pre-existing kidney disease (per study protocol)

Answer: D