Prolonged Ischemic Time, Delayed Graft Function, and Graft and Patient Outcomes in Live Donor Kidney Transplant Recipients

Anoushka Krishnan, Germaine Wong, J.R. R. Chapman, P.T. T. Coates, G.R. R. Russ, H. Pleass, C. Russell, B. He, Wai H. Lim

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    Abstract

    © Copyright 2016 The American Society of Transplantation and the American Society of Transplant SurgeonsThe association between prolonged cold ischemic time (CIT) and graft and patient outcomes in live donor kidney transplant recipients remains unclear. The aims of this study were to examine the association of CIT with delayed graft function and graft loss in live donor kidney transplant recipients and those who participated in the Australian Paired Kidney Exchange program using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) registry. Of 3717 live donor transplant recipients between 1997 and 2012 who were followed for a median of 6.6 years (25 977 person-years), 224 (25%) experienced CIT >4–8 h. Donor age was an effect modifier between CIT and graft outcomes. In recipients who received kidneys from older donors aged >50 years, every hour of increase in CIT was associated with adjusted odds of 1.28 (95% confidence interval [CI] 1.07–1.53, p = 0.007) for delayed graft function, whereas CIT >4–8 h was associated with adjusted hazards of 1.93 (95% CI 1.21–3.09, p = 0.006) and 1.91 (95% CI 1.05–3.49, p = 0.035) for overall and death-censored graft loss, respectively, compared with CIT of 1–2 h. Attempts to reduce CIT in live donor kidney transplants involving older donor kidneys may lead to improvement of graft outcomes.
    Original languageEnglish
    Pages (from-to)2714-2723
    Number of pages10
    JournalAmerican Journal of Transplantation
    Volume16
    Issue number9
    DOIs
    Publication statusPublished - 2016

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