Cold ischemia time and allograft outcomes in live donor renal transplantation: Is live donor organ transport feasible?

C. E. Simpkins, R. A. Montgomery, A. M. Hawxby, J. E. Locke, Sommer Elizabeth Gentry, Daniel Warren, Dorry Segev

Research output: Contribution to journalArticle

Abstract

One of the greatest obstacles to the implementation of regional or national kidney paired donation programs (KPD) is the need for the donor to travel to their matched recipient's hospital. While transport of the kidney is an attractive alternative, there is concern that prolonged cold ischemia time (CIT) would diminish the benefits of live donor transplantation (LDTx). To examine the impact of increased CIT in LDTx, 1-year serum creatinine (SCr), delayed graft function (DGF), acute rejection (AR) and allograft survival (AS) were analyzed in 38 467 patients by 2 h CIT groups (0-2, 2-4, 4-6 and 6-8 h) using data from the United Network for Organ Sharing/Organ Procurement and Transplantation Network (UNOS/OPTN). Adjusted probabilities of DGF and AR were estimated in multivariate logistic regression models and AS was examined in multivariate Cox proportional hazards models. Although some increase in DGF was observed between the 0-2 h (4.7%) and 4-6 h (8.3%) groups, prolonged CIT did not result in inferior SCr, increased AR or compromised AS in any group with >2 h CIT compared with the 0-2 h group. Comparable long-term outcomes for these grafts suggests that transport of live donor organs may be a feasible alternative to donor travel in KPD regions where CIT can be limited to 8 h.

Original languageEnglish (US)
Pages (from-to)99-107
Number of pages9
JournalAmerican Journal of Transplantation
Volume7
Issue number1
DOIs
Publication statusPublished - Jan 2007

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Keywords

  • Donor exchange
  • Live donor renal transplantation
  • Organ shipping
  • Paired donation
  • Paired kidney exchange

ASJC Scopus subject areas

  • Immunology

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