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Is prolonged cold ischemia a contraindication to using kidneys from acute kidney injury donors?
Author(s) -
Orlando Giuseppe,
Khan Muhammad A.,
ElHennawy Hany,
Farney Alan C.,
Rogers Jeffrey,
ReevesDaniel Amber,
Gautreaux Michael D.,
Doares William,
Kaczmorski Scott,
Stratta Robert J.
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13185
Subject(s) - medicine , contraindication , acute kidney injury , renal function , kidney transplantation , retrospective cohort study , single center , kidney , transplantation , surgery , incidence (geometry) , urology , pathology , alternative medicine , physics , optics
To determine the impact of prolonged cold ischemia time ( CIT ) on the outcome of acute kidney injury ( AKI ) renal grafts, we therefore performed a single‐center retrospective analysis in adult patients receiving kidney transplantation ( KT ) from AKI donors. Outcomes were stratified according to duration of CIT . A total of 118 patients receiving AKI grafts were enrolled. Based on CIT , patients were stratified as follows: (i) <20 hours, 27 patients; (ii) 20‐30 hours, 52 patients; (iii) 30‐40 hours, 30 patients; (iv) ≥40 hours, nine patients. The overall incidence of delayed graft function DGF was 41.5%. According to increasing CIT category, DGF rates were 30%, 42%, 40%, and 78%, respectively ( P = .03). With a mean follow‐up of 48 months, overall patient and graft survival rates were 91% and 81%. Death‐censored graft survival ( DCGS ) rates were 84% and 88% for patients with and without DGF ( P = NS ). DCGS rates were 92% in patients with CIT <20 hours compared to 85% with CIT >20 hours ( P = NS ). In the nine patients with CIT >40 hours, the 4‐year DCGS rate was 100%. We conclude that prolonged CIT in AKI grafts may not adversely influence outcomes and so discard of AKI kidneys because of projected long CIT is not warranted when donors are wisely triaged.