Related Experiment Videos
Successful renal transplantation with cadaveric donor kidneys of extremely prolonged cold ischaemic time
S F Lui1, J F Moorhead, Z Varghese
1Department of Nephrology and Transplantation, Royal Free Hospital, London, UK.
Insights
Kidney transplants with prolonged cold ischemic times (60 hours) show similar renal function and survival to those with shorter times (20 hours). Low-dose cyclosporine A is safe for these extended-time kidney grafts.
Area of Science:
- Nephrology
- Transplantation immunology
- Organ preservation
Background:
- Prolonged cold ischemic time (CIT) is a significant concern in kidney transplantation.
- Optimizing organ utilization is crucial for addressing organ shortages.
Purpose of the Study:
- To evaluate the safety and efficacy of using cadaveric donor kidneys with extremely prolonged cold ischemic times (CIT).
- To compare renal function, survival, primary non-function, and rejection episodes between prolonged and shorter CIT kidney grafts.
Main Methods:
- Retrospective analysis of renal transplant recipients.
- Comparison of outcomes between two groups: extremely prolonged CIT (median 60h) and shorter CIT (median 20h).
- Assessment of renal function, patient survival, primary non-function, and rejection episodes at 3, 6, and 12 months post-transplant.
Main Results:
- No significant difference in renal function and survival at 12 months between prolonged and shorter CIT groups.
- Higher incidence of primary non-function in the prolonged CIT group, but similar duration of non-function.
- Significantly fewer rejection episodes observed in the prolonged CIT group.
- Demonstrated safety of low-dose cyclosporine A in kidney grafts with extremely prolonged CIT.
Conclusions:
- Extremely prolonged cold ischemic time does not adversely affect long-term renal function or survival in kidney transplant recipients.
- Low-dose cyclosporine A is a safe immunosuppressive strategy for kidney grafts with extended CIT.
- Careful patient selection and management can mitigate risks associated with prolonged CIT kidney transplantation.
Abstract:
At 3, 6 and 12 months, there was no difference in renal function and survival between a group of renal transplant recipients who received cadaveric donor kidneys of extremely prolonged cold ischaemic time (group median 60 h; range 35-82 h), compared to a group who received cadaveric donor kidneys of shorter cold ischaemic time (group median 20 h; range 6-44 h). The prolonged cold ischaemic time group had a higher incidence of primary non-function, but the duration of primary non-function was not different between the two groups. The prolonged cold ischaemic time group had significantly fewer episodes of rejection. Despite the increased incidence of primary non-function, this study shows that it is safe to use low-dose cyclosporin A in kidney grafts with an extremely prolonged cold ischaemic time.