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| Home > Publications database > Cold ischemia time exceeding 12 hours is a risk factor for delayed graft function and increased mortality in kidney transplant recipients within the eurotransplant senior program. |
| Home > Publications database > Cold ischemia time exceeding 12 hours is a risk factor for delayed graft function and increased mortality in kidney transplant recipients within the eurotransplant senior program. |
| Journal Article | DKFZ-2026-01633 |
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2026
Frontiers Media
Lausanne
Abstract: With the age of those awaiting kidney transplantation (KTx) increasing, the Eurotransplant Senior Program (ESP) reduces median waiting time by > 1.5 years for patients aged ≥65 compared to standard allocation and doubles life expectancy compared with remaining on dialysis. However, older-donor organs are more vulnerable to prolonged cold ischemia time (CIT). To minimize CIT, both kidneys from one donor are regionally allocated, in our case, to a single transplant center. This study assesses the impact of CIT on delayed graft function (DGF) and long-term outcomes in consecutively transplanted ESP recipients from the same donor. We retrospectively analyzed 208 ESP KTx at Freiburg Transplant Center (1999-2019), focusing on 74 consecutively transplanted kidney pairs (recipients ranked '1' or '2'). DGF incidence was similar for rank 1 and rank 2 recipients. CIT >12 h significantly increased DGF risk versus CIT <8 h (adjusted OR 6.30; 95% CI 1.52-26.06; p = 0.011). Death-censored allograft survival was unaffected, but CIT >12 h tripled mortality risk (adjusted HR 3.19; 95% CI 1.44-7.49; p = 0.005). Consecutive transplantation does not disadvantage the second recipient if CIT remains <12 h. CIT >12 h independently predicts DGF and higher mortality, emphasizing the need to minimize ischemia time.
Keyword(s): Humans (MeSH) ; Kidney Transplantation: mortality (MeSH) ; Kidney Transplantation: adverse effects (MeSH) ; Cold Ischemia: adverse effects (MeSH) ; Delayed Graft Function: etiology (MeSH) ; Delayed Graft Function: mortality (MeSH) ; Retrospective Studies (MeSH) ; Female (MeSH) ; Risk Factors (MeSH) ; Male (MeSH) ; Graft Survival (MeSH) ; Time Factors (MeSH) ; Middle Aged (MeSH) ; Aged (MeSH) ; cold ischemia time ; delayed graft function ; eurotransplant senior program ; kidney transplantation ; mortality
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