What are we waiting for? Analyses of factors influencing cold ischemia time.

ABSTRACT

INTRODUCTION: Cold ischemia time (CIT) influences long-term graft survival after deceased donor (DD) kidney transplantation. The aim of the present study was to identify factors that influenced CIT at our institution, seeking to lay ground for improvement. PATIENTS AND METHODS: Patients who underwent DD kidney transplantations from November 2008 to April 2009 were included in the study. In a prospective protocol the times for various events were registered. The 40 DD kidney transplantations included 26 "paired" kidneys from the same donor and 14 "single" kidneys. RESULTS: The mean CIT was 15.2 hours ± 4.2 hours (range, 7.0-23.9). "First kidney" was 13.3 hours ± 3.4 versus 19.2 ± 2.8 hours for the "second kidney" (P < .001). The waiting time for the operating room (OR) was 2.4 hours (range, 0-12 hours). Twenty-five percent of the patients waited more than 4 hours. Patients arriving at the hospital at the same time as or before the kidney retrieval showed a CIT of 13.4 ± 3.9 hours compared with 17.4 ± 3.4 hours for patients that arrived after the retrieved kidney (P < .01). CONCLUSION: We identified factors influencing CIT that could lay the foundation for improvement. An extended cooperation and exchange with another transplantation unit for the "second kidney" could reduce the CIT. To reduce the waiting time for OR at the hospital to less than 2 hours and to get the recipient into the hospital before the kidney arrives are efforts that could reduce CIT.