Donor Age, Cold Ischemia Time, and Delayed Graft Function

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Helanterä , I , Ibrahim , H N , Lempinen , M & Finne , P 2020 , ' Donor Age, Cold Ischemia Time, and Delayed Graft Function ' , Clinical journal of the American Society of Nephrology , vol. 15 , no. 6 , pp. 813-821 .

Title: Donor Age, Cold Ischemia Time, and Delayed Graft Function
Author: Helanterä, Ilkka; Ibrahim, Hassan N.; Lempinen, Marko; Finne, Patrik
Contributor organization: HUS Abdominal Center
Nefrologian yksikkö
IV kirurgian klinikka
Helsinki University Hospital Area
University of Helsinki
Department of Medicine
Date: 2020-06-08
Language: eng
Number of pages: 9
Belongs to series: Clinical journal of the American Society of Nephrology
ISSN: 1555-9041
Abstract: Background and objectives Increased donor age is one of the most important risk factors for delayed graft function (DGF), and previous studies suggest that the harmful effect of cold ischemia time is increased in kidneys from older donors. Our aim was to study the association of increased donor age and cold ischemia time with the risk of delayed graft function in a large cohort kidney transplants from the current era. Design, setting, participants, & measurements The Scientific Registry of Transplant Recipients was used for this observational, retrospective registry analysis to identify all deceased donor kidney transplantations in the United States between 2010 and September 2018, who were on dialysis pretransplantation (n=90,810). The association of donor age and cold ischemia time with the risk of DGF was analyzed in multivariable models adjusted for recipient characteristics (age, race, sex, diabetes, calculated panel-reactive antibodies, pretransplant dialysis duration) and donor characteristics (cause of death, sex, race, body mass index, creatinine, donation after circulatory death status, history of hypertension, and HLA mismatch). Results Cold ischemia time and donor age were independently associated with the risk of DGF, but the risk of DGF was not statistically significantly lower in donor age categories between 50 and 64 years, compared with donors ?65 years. The harmful association of cold ischemia time was not higher in kidneys from older donors in any age category, not even among donation after circulatory death donors. When donor risk was assessed with kidney donor profile index, although a statistically significant interaction with cold ischemia time was found, no practically meaningful increase in cold-ischemia susceptibility of kidneys with a high kidney donor profile index was found. Conclusions We were unable to demonstrate an association between donor age and DGF. The association of longer cold ischemia time with the risk of DGF was not magnified in older or more marginal donors.
Subject: Epidemiology and outcomes
transplant outcomes
cadaver organ transplantation
delayed graft function
Cold Ischemia
kidney transplantation
Retrospective Studies
Transplant Recipients
risk factors
Cause of Death
Body Mass Index
renal dialysis
Tissue Donors
Kidney Diseases
diabetes mellitus
Cohort Studies
3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: acceptedVersion

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