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Indian J Nephrol. 2019 Jan-Feb;29(1):8-14. doi: 10.4103/ijn.IJN_162_18.

Time of Cold Ischemia and Delayed Graft Function in a Cohort of Renal Transplant Patients in a Reference Center.

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Department of Nephrology Kidney Transplant, Hospital Pablo Tobón Uribe, Medellin, Colombia.
Department of Internal Medicine, University of Antioquia, Medellin, Colombia.
Deparment of Internal Medicine, Faculty of Medicine, Universidad Pontificia Bolivariana, Medellin, Colombia.
Faculty of Medicine, Institute for Clinical Epidemiology and Applied Biometrics, Eberhard Karls University, Tuebingen, Germany.


There are many factors involved in the delayed graft function of a renal graft, with prolonged cold ischemia time being one of the most relevant. The aim of this study is to evaluate the relationship between the time of cold ischemia and the delayed graft function, and acute rejection and graft loss at 1 year of follow-up. A retrospective cohort of 347 renal transplant patients were evaluated during the years 2009-2013. The incidence of delayed graft function was 18.4% (n = 65). The cold ischemia time was an independent risk factor for delayed graft function (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.04-1.16). By grouping the time of cold ischemia by intervals, the risk of delayed graft function was greater in the 12-18 hours group (OR 2.06, 95% CI 1.02-4.15) and in the >18 hours group (OR 3.38, 95% CI 1.57-7.27). The risk of acute rejection did not increase with longer cold ischemia (p = 0.69), and cold ischemia time was not a risk factor for renal graft loss at 1-year follow-up (hazard ratio 0.97, 95% CI 0.88-1.06). In conclusion the time of cold ischemia (>12 hours) in renal transplant recipients of optimal deceased donors increases the risk of delayed graft function; however, this does not negatively impact the results in acute rejection or graft loss in the first year of the transplant.


Acute rejection; cold ischemia time; delayed graft function; graft loss; immunosuppression; kidney transplantation

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