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. 2017 Jun 27;3(7):e184.
doi: 10.1097/TXD.0000000000000668. eCollection 2017 Jul.

Influence of Cold Ischemia Time in Kidney Transplants From Small Pediatric Donors

Liise K Kayler  1 , Michelle Lubetzky  2 , Xia Yu  3 , Patricia Friedmann  3
Affiliations

Influence of Cold Ischemia Time in Kidney Transplants From Small Pediatric Donors

Liise K Kayler et al. Transplant Direct. .

Abstract

Background: Clinicians may be reluctant to transplant small pediatric kidneys that have prolonged cold ischemia time (CIT) for fear of an additional deleterious effect because pediatric grafts are thought to be more sensitive to ischemia. We aimed to assess the risks associated with transplantation of small pediatric kidneys with prolonged CIT.

Methods: We performed a retrospective cohort study examining US registry data between 1998 and 2013 of adult first-time kidney-only recipients of small pediatric kidneys from donors weighing 10 to 20 kg, stratified by CIT levels of 0 to 18 (n = 1413), 19 to 30 (n = 1116), and longer than 30 (n = 338) hours.

Results: All-cause graft survival by CIT groups at 1-year was 92%, 88%, and 89%, respectively. 1-year risk-adjusted graft survival hazard ratios were significantly higher with CIT of 19 to 30 hours (adjusted hazard ratios, 1.37; 95% confidence interval, 1.04-1.81) and somewhat higher with CIT greater than 30 hours (adjusted hazard ratios, 1.24; 95% confidence interval, 0.82-1.88) relative to recipients with CIT 0 to 18 hours. There was little variation in the effect of CIT on graft survival when restricted to single kidney transplants only and no significant interaction of CIT category and single kidney transplantation (P = 0.93).

Conclusions: Although prolonged CIT is associated with lower early graft survival in small pediatric donor kidney transplants, absolute decreases in 1-year graft survival rates were 3% to 4%.

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Conflict of interest statement

The data reported here have been supplied by the Minneapolis Medical Research Foundation as the contractor for the Scientific Registry of Transplant Recipients. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the Scientific Registry of Transplant Recipients or the US Government. No other authors received support for this study and there are no other conflicts of interest.

Figures

FIGURE 1
FIGURE 1
All cause graft survival of small pediatric kidneys from donors 10 to 20 kg single and en bloc transplants by CIT group.
FIGURE 2
FIGURE 2
All cause graft survival of small pediatric kidneys from donors 10 to 20 kg single transplants.
FIGURE 3
FIGURE 3
Patient survival of small pediatric kidneys from donors 10 to 20 kg single and en bloc transplants.
See this image and copyright information in PMC

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References

    1. Maluf DG, Carrico RJ, Rosendale JD, et al. Optimizing recovery, utilization and transplantation outcomes for kidneys from small, ≤20 kg, pediatric donors. Am J Transplant. 2013;13:2703–2712. - PubMed
    1. Yagisawa T, Kam I, Chan L, et al. Limitations of pediatric donor kidneys for transplantation. Clin Transplant. 1998;12:557–562. - PubMed
    1. Harmon WE, Stablein D, Alexander SR, et al. Graft thrombosis in pediatric renal transplant recipients. A report of the North American Pediatric Renal Transplant Cooperative Study. Transplantation. 1991;51:406–412. - PubMed
    1. Schneider JR, Sutherland DE, Simmons RL, et al. Long-term success with double pediatric cadaver donor renal transplants. Ann Surg. 1983;197:439–442. - PMC - PubMed
    1. Burrows L, Knight R, Polokoff E, et al. Expanding the donor pool with the use of en bloc pediatric kidneys in adult recipients. Transplant Proc. 1996;28:173–174. - PubMed