Extraction time of kidneys during organ procurement impacts function

It is well established that ischemic times affect rates of delayed graft function (DGF) and allograft survival following deceased donor kidney transplant. There is, however, a paucity of data regarding what we term extraction time, the time between aortic cross-clamp and perfusion/cooling, and removal of the kidneys from the body and placement on ice on the back table. We posit that this time is an additional insult, and may significantly contribute to transplant kidney function. Data pooled from May 2003 to December 2004 from the local OPO (Gift of Life) and UNOS included 316 transplanted kidneys (28 en bloc and 52 donation after cardiac death excluded). Retrospective review and statistical analysis of donor, recipient, and transplant characteristics were performed. When divided into 30-minute intervals, extraction time was found to directly correlate with early graft failure, (rates 0%, 8.1%, and 14.5%, Spearman's rank correlation p < 0.05). DGF rates were not tied to extraction time, but shorter extraction time was strongly associated with recovery from DGF and eventual kidney function. Further studies are needed to better assess this factor and its impact.