Shorter Cold Ischemia Time in Deceased Donor Kidney Transplantation Reduces the Incidence of Delayed Graft Function Especially Among Highly Sensitized Patients and Kidneys From Older Donors

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Lauronen , J , Peräsaari , J P , Saarinen , T , Jaatinen , T , Lempinen , M & Helanterä , I 2020 , ' Shorter Cold Ischemia Time in Deceased Donor Kidney Transplantation Reduces the Incidence of Delayed Graft Function Especially Among Highly Sensitized Patients and Kidneys From Older Donors ' , Transplantation Proceedings , vol. 52 , no. 1 , pp. 42-49 . https://doi.org/10.1016/j.transproceed.2019.11.025

Title: Shorter Cold Ischemia Time in Deceased Donor Kidney Transplantation Reduces the Incidence of Delayed Graft Function Especially Among Highly Sensitized Patients and Kidneys From Older Donors
Author: Lauronen, Jouni; Peräsaari, Juha P.; Saarinen, Timo; Jaatinen, Taina; Lempinen, Marko; Helanterä, Ilkka
Contributor: University of Helsinki, Finnish Red Cross Blood Service
University of Helsinki, HUS Children and Adolescents
University of Helsinki, Finnish Red Cross Blood Service
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Abdominal Center
Date: 2020-01
Language: eng
Number of pages: 8
Belongs to series: Transplantation Proceedings
ISSN: 0041-1345
URI: http://hdl.handle.net/10138/313369
Abstract: Background. Long cold ischemia time (CIT) is the most important factor contributing to delayed graft function (DGF) after kidney transplant. Improvements in pretransplant procedures may reduce CIT and improve clinical outcome. Materials and Methods. Pretransplant histocompatibility tests were modernized at our laboratory in 2015, leading to significant decrease of time consumed for these enabling earlier surgery. The effects of this on kidney transplant CIT, DGF, and other clinical outcomes were studied. The study population consisted of 896 consecutive deceased donor kidney recipients, of which 442 patients received a transplant with the old crossmatch and 454 received a transplant with the new crossmatch. Results. CIT shortened from mean 20 hours 6 minutes to 15 hours 52 minutes (P <.001). The incidence of DGF was significantly reduced from 31% to 24% (P = .02). Reduction in the frequency of DGF was more pronounced among the highly sensitized patients (53% to 28%, P = .01) or in patients with pretransplant donor-specific antibodies (50% to 20%, P = .002) and among patients who received kidneys from donors older than 65 years (38% to 27%, P = .04). Conclusions. Process optimization that reduces CIT decreases occurrence of DGF, especially in highly sensitized patients and patients who receive kidneys from older donors.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
LEUKOCYTE ANTIGEN ANTIBODIES
CROSS-MATCH TEST
SELECTIVE OMISSION
HLA ANTIBODIES
PREDICTION
EXPERIENCE
STORAGE
RISK
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