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

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 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).