Reduction of Cold Ischemia Time and Anastomosis Time Correlates with Lower Delayed Graft Function Rates Following Transplantation of Marginal Kidneys.

Abstract:

:BACKGROUND In kidney transplantation, the association of cold ischemia time (CIT), anastomosis time (AT), and delayed graft function (DGF) is particularly detrimental in grafts from marginal donors; however, actual cut-off criteria are still debated. MATERIAL AND METHODS Data from patients >65 years (n=193) and patients <65 years (n=1054) transplanted between 2000 and 2010 were retrospectively analyzed regarding the age-dependent impact of ischemia times and DGF. RESULTS Overall death censored graft survival was inferior for ECD/DCD organs. Graft survival was significantly impaired by DGF in younger and older recipients. The multivariate analysis revealed an age-dependent profile of risk factors for DGF. In younger patients, multiple risk factors were identified while in patients >65 years, only CIT and AT were correlated with DGF. Marginal grafts with a CIT<769 min had a comparable outcome to any SCD organ; extended CIT >770 min worsened ECD/DCD survival significantly. Similarly, AT longer than 26 min was associated with a significantly impaired survival of ECD/DCD grafts. In a Cox regression analysis with penalized splines, this increased risk of graft loss was not linear: CIT beyond 800 min and AT beyond 20 min were cut-off values associated with worse outcomes in marginal organs. CONCLUSIONS Thus, risk factors for DGF are age-dependent; keeping ischemia times below these thresholds offers outcome of ECD/DCD organs comparable to SCD organs.

journal_name

Ann Transplant

authors

Denecke C,Biebl M,Fritz J,Brandl A,Weiss S,Dziodzio T,Aigner F,Sucher R,Bösmüller C,Pratschke J,Öllinger R

doi

10.12659/aot.896672

subject

Has Abstract

pub_date

2016-05-31 00:00:00

pages

246-55

eissn

1425-9524

issn

2329-0358

pii

896672

journal_volume

21

pub_type

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