Related Experiment Video
Updated: Mar 20, 2026
Murine Kidney Transplant Technique
Published on: October 20, 2015
Effect of cold ischaemia time on outcome after living donor renal transplantation
J Nath1,2, J Hodson3, S W Canbilen2
1Departments of Renal Surgery, University Hospital Birmingham NHS Trust, Birmingham, UK.
Insights
Cold ischaemia time (CIT) up to 8 hours has a marginal detrimental effect on living donor kidney transplants. Patient survival remains unaffected, with excellent graft outcomes even with longer CIT.
Area of Science:
- Nephrology
- Transplantation immunology
- Organ preservation
Background:
- Cold ischaemia time (CIT) is a critical factor in kidney transplantation.
- Understanding its impact on living donor kidney transplant recipients is essential for optimizing outcomes.
Purpose of the Study:
- To evaluate the effects of varying cold ischaemia times on living donor kidney transplant recipients.
- To analyze a large national dataset to assess patient and graft survival in relation to CIT.
Main Methods:
- Analysis of UK National Health Service Blood and Transplant and UK Renal Registry data (2001-2014).
- Categorization of 9156 living donor kidney transplants into three CIT groups: <2h, 2-4h, and 4-8h.
- Multivariable analysis to risk-adjust outcomes based on donor and recipient characteristics.
Main Results:
- No significant difference in patient survival across all CIT groups.
- Kidneys with CIT of 4-8h showed excellent graft outcomes, slightly inferior to <2h CIT.
- Risk-adjusted delayed graft function rates were 8.6% for 4-8h CIT vs. 4.3% for <2h CIT.
- 1-year graft survival rates were 96.2% for 4-8h CIT vs. 97.1% for <2h CIT.
Conclusions:
- Prolonging cold ischaemia time up to 8 hours has a marginal detrimental effect in living donor kidney transplantation.
- Current CIT durations appear safe, with minimal impact on long-term graft survival and no effect on patient survival.
Background:
The aim of the present study was to determine the effects of cold ischaemia time (CIT) on living donor kidney transplant recipients in a large national data set.
Methods:
Data from the National Health Service Blood and Transplant and UK Renal Registry databases for all patients receiving a living donor kidney transplant in the UK between January 2001 and December 2014 were analysed. Patients were divided into three groups depending on CIT (less than 2 h, 2-4 h, 4-8 h). Risk-adjusted outcomes were assessed by multivariable analysis adjusting for discordance in both donor and recipient characteristics.
Results:
Outcomes of 9156 transplants were analysed (CIT less than 2 h in 2662, 2-4 h in 4652, and 4-8 h in 1842). After adjusting for confounders, there was no significant difference in patient survival between CIT groups. Recipients of kidneys with a CIT of 4-8 h had excellent graft outcomes, although these were slightly inferior to outcomes in those with a CIT of less than 2 h, with risk-adjusted rates of delayed graft function of 8·6 versus 4·3 per cent, and 1-year graft survival rates of 96·2 versus 97·1 per cent, respectively.
Conclusion:
The detrimental effect of prolonging CIT for up to 8 h in living donation kidney transplantation is marginal.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure