Mujeeb, Mariyam; Borbas, Balint; Tanase, Andrei; Sandhu, Bynvant; Barnett, Nicholas; Zakri, Rhana; Dabare, Dilan; ... Aroori, Somaiah; + view all Mujeeb, Mariyam; Borbas, Balint; Tanase, Andrei; Sandhu, Bynvant; Barnett, Nicholas; Zakri, Rhana; Dabare, Dilan; Patel, Kamlesh; Okafor, Ugochukwu; Ayorinde, Tobi; Chan, Abigail; Hanji, Suresh; Motallebzadeh, Reza; Alawad, Awad; Brooker, Verity; Chalklin, Christopher; Gupta, Sapna; Szabo, Laszlo; Malik, Ahmed; Mustafa, Omer; Ghazanfar, Abbas; Soliman, Haitham; Storey, Rowland; Petrosius, Gintaras; Tariq, Khadija; Boffa, Catherine; Sutaria, Rupesh; Gopal, Jeevan; Khambalia, Hussein; Moinuddin, Zia; Prabakaran, Viswakumar; Khattab, Rania; Amer, Aimen; Martin, Laura; Houston, Susannah; Jackson, Andrew; Mayaleh, Sameh; Rizzello, Anna; Shankar, Sushma; Sinha, Sanjay; Arachchige, Sachith; Konstantinou, Charalampos; Muhammad, Kama; O'Callaghan, John; Hamaoui, Karim; Russel, Neil; Aroori, Somaiah; - view fewer (2025) Causes of Prolonged Cold Ischemia Time After Arrival of Deceased Donor Kidney at Implanting Center: Results From a Prospective Audit. Clinical Transplantation , 39 (8) , Article e70227. 10.1111/ctr.70227.

Text Motallebzadeh_Causes of Prolonged Cold Ischemia Time After Arrival of Deceased Donor Kidney at Implanting Center_AAM.pdf Access restricted to UCL open access staff until 7 August 2026. Download (311kB)

Abstract

BACKGROUND: Deceased donor kidney transplants often face delays, leading to prolonged cold ischemia time (CIT), yet data on post-allograft arrival delays are scarce. OBJECTIVES: This audit aims to identify and characterize the delays contributing to CIT prolongation after allograft arrival at the implanting center. DESIGN: Data was collected prospectively from 14 UK centers between February and September 2022. Timelines from allograft arrival to the implanting center to implantation were recorded for adult deceased donor kidney-only transplants. RESULTS: The median CIT for all 446 allografts [(donation after cardiac death (DCD), 48.2% and donation after brain death (DBD), 51.6%)] was 11:08 h (interquartile range (IQR): 08:15–15:12). A total of 42% of DCD and 15% of DBD allografts exceeded the national recommended duration of 12 and 18 h, respectively. CIT was prolonged in centers with dedicated transplant theaters, with a median CIT of 13:41 (IQR: 08:11–15:13) compared to a median CIT of 09:43 (IQR: 07:36–12:29) hours (p < 0.005, 95% CI: −4.40, −2.60) in centers without dedicated transplant theaters. Compared to full cross-match (FXM) results, a higher proportion of Virtual cross-match (VXM) results (75.2% vs. 89.4%, Odds Ratio (OR): 2.79, CI: 1.57–5.0, p < 0.005) were available before the allograft arrived at the implanting center. The proportion of crossmatch results available before the recipient's arrival at the implanting center was 31.7% (46.6% for VXM vs. 4.9% for FXM, OR: 16.76, CI: 7.50, 44.17, p < 0.005). However, no difference was found in CIT between the VXM (median: 11:06, IQR: 08:14–15:20) and FXM (median: 11:00, IQR: 08:34–14:56) groups (p = 0.75, CI: −0.75, 1.02). Qualitative analysis identified theater and staff unavailability as common reasons for delay. CONCLUSION: Internal center practices have a significant impact on CIT, necessitating intervention to optimize transplant outcomes.

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