Effect of cold ischaemia time on outcome after living donor renal transplantation

Br J Surg. 2016 Aug;103(9):1230-6. doi: 10.1002/bjs.10165. Epub 2016 Jun 1.

Abstract

Background: The aim of the present study was to determine the effects of cold ischaemia time (CIT) on living donor kidney transplant recipients in a large national data set.

Methods: Data from the National Health Service Blood and Transplant and UK Renal Registry databases for all patients receiving a living donor kidney transplant in the UK between January 2001 and December 2014 were analysed. Patients were divided into three groups depending on CIT (less than 2 h, 2-4 h, 4-8 h). Risk-adjusted outcomes were assessed by multivariable analysis adjusting for discordance in both donor and recipient characteristics.

Results: Outcomes of 9156 transplants were analysed (CIT less than 2 h in 2662, 2-4 h in 4652, and 4-8 h in 1842). After adjusting for confounders, there was no significant difference in patient survival between CIT groups. Recipients of kidneys with a CIT of 4-8 h had excellent graft outcomes, although these were slightly inferior to outcomes in those with a CIT of less than 2 h, with risk-adjusted rates of delayed graft function of 8·6 versus 4·3 per cent, and 1-year graft survival rates of 96·2 versus 97·1 per cent, respectively.

Conclusion: The detrimental effect of prolonging CIT for up to 8 h in living donation kidney transplantation is marginal.

MeSH terms

  • Adult
  • Cold Ischemia / statistics & numerical data*
  • Databases, Factual
  • Female
  • Graft Survival
  • Humans
  • Kidney Transplantation / methods*
  • Kidney Transplantation / mortality
  • Living Donors*
  • Male
  • Middle Aged
  • Models, Statistical
  • Organ Preservation / methods*
  • Outcome Assessment, Health Care
  • Registries
  • Time Factors