Cold Ischemia Time Tied to Delayed Kidney Graft Function

But, no effect on kidney graft survival among expanded criteria donor kidney transplants

MONDAY, Sept. 19 (HealthDay News) -- Increasing cold ischemia time (CIT) in expanded-criteria donor (ECD) kidney pairs is a risk factor for delayed graft function (DGF), but has no effect on graft survival, according to a study published online Sept. 11 in the American Journal of Transplantation.

Liise K. Kayler, M.D., from the Shands Hospital at the University of Florida Gainesville, and colleagues investigated the effect of CIT in paired ECD kidneys (derived from the same donor transplanted to different recipients) transplanted between 1995 and 2009. Of these, 14,230 paired ECD kidneys (7,115 donors) were included in the analysis after excluding 3,286 with the same CIT.

The investigators found a median difference of five hours in CIT. The possibility of DGF was significantly higher in pairs with greater CIT (35 versus 31 percent), with considerably higher rates for CIT differences of 15 hours or more. The difference in overall graft loss was not significant between recipients with a higher CIT compared to paired donor recipients with a lower CIT, or for pairs with CIT differences of one to three hours, four to nine hours, 10 to 14 hours, or 15 hours or more. Consistent results were observed in multivariable models after adjusting for recipient factors.

"Although increasing cold ischemia time is a risk factor for DGF among ECD kidney transplants, there is no effect on graft survival which may suggest an important utility for donor kidneys that may not currently be considered viable," the authors write.

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