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Arch Surg. 2000 Sep;135(9):1016-9; discussion 1019-20.

Prolonged cold ischemia time obviates the benefits of 0 HLA mismatches in renal transplantation.

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  • 1Division of Transplantation, Department of Surgery, Box 0780, University of California-San Francisco, 513 Parnasus Ave, San Francisco, CA 94143-0780, USA. robertsj@surgery.ucsf.edu

Abstract

HYPOTHESIS:

Recipients of 0 HLA mismatch kidneys with prolonged cold ischemia times of longer than 36 hours do not have superior outcomes compared with recipients of kidneys with 1 or more mismatches.

DESIGN:

Retrospective review.

SETTING:

Transplanation centers.

PATIENTS AND METHODS:

A total of 63,688 recipients who underwent transplantation between January 1, 1990, and July 31, 1998.

MAIN OUTCOME MEASURES:

Delayed graft function, serum creatinine level, and patient and renal graft survival.

RESULTS:

Recipients of 0 HLA mismatch kidneys with fewer than 36 hours of cold ischemia time had better 5-year graft survival (75%) when compared with recipients with 1 or more mismatches (67%) (P<.001). However, recipients of 0 HLA mismatch kidneys with longer than 36 hours of cold ischemia time did not have any graft survival advantage (71% in 0 HLA mismatch kidneys vs 72% in 1 or more mismatches, P =.24).

CONCLUSIONS:

Cold ischemia times of longer than 36 hours obviate the benefits of better graft survival conferred by better matching.

Comment in

PMID:
10982503
[PubMed - indexed for MEDLINE]
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