Kidney Transplant Outcomes for Prolonged Cold Ischemic Times in the Context of Kidney Paired Donation

Date created: 
2017-07-21
Identifier: 
etd10251
Keywords: 
Living donor kidney transplantation
Kidney paired donation
Cold ischemia time
Delayed graft function
Survival
Abstract: 

The need for kidneys outweighs the current organ supply. This study examines the impact of longer cold ischemic time (CIT) on graft outcomes to help expand living donor transplantation in kidney paired donation (KPD). In a retrospective cohort study of 48,498 living donor (LD) recipients in the United States between 2005-15, multivariate survival analyses reveal no association between CIT <16 hours for all-cause graft loss, or death-censored graft loss (hazard ratios for CIT 8.0-16.0 hours (0.97; 95% CI 0.74-1.26) and (1.09; 95% CI 0.81-1.48) respectively, compared to CIT 0.1-2.0 hours). These results were robust in LD >50 years and in KPD and non-KPD transplants. While there was a higher incidence of delayed graft function (DGF) in groups with longer CIT, the overall incidence of DGF was low. Multivariate regression analyses show increased odds of DGF only in CIT 8.1-16 hours compared to 0.1-2.0 hours (odds ratio: 1.47; 95% CI 1.05-2.05).

Document type: 
Thesis
Rights: 
This thesis may be printed or downloaded for non-commercial research and scholarly purposes. Copyright remains with the author.
File(s): 
Senior supervisor: 
Malcolm Steinberg
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) M.P.H.
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