Decrease in cold ischemic times as a result of protocol changes of urgent immunogenetic testing during cadaveric...

Area of Science:

• Nephrology
• Transplantation immunology
• Medical laboratory science

Background:

• Hungary revised its urgent immunogenetics testing protocol for cadaveric kidney transplantation on January 1, 2011.
• The updated procedure permits HLA typing and crossmatching of donors using peripheral blood before the declaration of brain death.

Purpose of the Study:

• To evaluate the impact of the procedural change on key kidney transplantation indicators.
• Specifically, to compare cold ischemic time (CIT) between pre- and post-change periods.

Main Methods:

• A comparative analysis of kidney transplant data from January 1, 2010, to October 31, 2010 (n=114) and January 1, 2011, to October 31, 2011 (n=91).
• Systematic collection of CIT for both kidneys, laboratory turnaround times (TAT), and recipient preparation times.

Main Results:

• CIT for the first kidney decreased from 16.5 ± 3.5 to 12.4 ± 3.2 hours (P < .001).
• CIT for the second kidney decreased from 19.8 ± 3.4 to 16.0 ± 3.8 hours (P < .001).
• Laboratory TAT increased, and recipient preparation time significantly increased.

Conclusions:

• The revised protocol led to a significant reduction in CIT for both kidneys.
• This reduction in CIT may contribute to improved short-term kidney transplant outcomes.
• The procedural change allowed for increased recipient preparation time, potentially enhancing transplant success.