Preservation.
1. There were no significant differences in 1-year graft survival rates comparing kidneys stored with 3 commonly used cold storage solutions (Collins', EuroCollins, and University of Wisconsin) over the past 12 years, even though preferences have changed sharply. 2. No significant differences in 1-year graft survival rates were noted when comparing kidneys preserved by pump perfusion and those maintained by simple cold storage. The lower incidence of delayed graft function for pump-preserved kidneys was at least partly attributable to a center effect. 3. Prolonged cold ischemia time (CIT) was associated with an increase in delayed onset of function. Of 2,718 kidneys transplanted within 24 hours, 21% did not function well within the first week. The fraction increased to 28% and 33% of kidneys transplanted between 25 and 36 hours (n = 1,858) and after 36 hours (n = 955), respectively (p < 0.01). One-year graft survival rates were 82%, 78%, and 76% for kidneys transplanted within 24 hours, between 25 and 36 hours, and after 36 hours, respectively (p < 0.01, each comparison). 4. HLA matching neutralized the impact of prolonged CIT completely. One-year graft survival was more than 86% in 715 recipients of 0 HLA-mismatched kidneys, regardless of CIT. For recipients of mismatched transplants, survival decreased by 5-6% as CIT increased from less than 24 to more than 36 hours (p < 0.01). Of the mis-matched kidneys with less than 24 hours CIT, up to 83% survived at 1 year compared with 87% of matched kidneys with more than 36 hours CIT (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Zhou
Y C
YC
Cecka
J M
JM
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003080:Cold Temperature; D006085:Graft Survival; D006680:HLA Antigens; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods* / Q000706:statistics & numerical data; D012042:Registries; D015996:Survival Rate; D014019:Tissue Donors; D014481:United States / Q000453:epidemiology
D006680:HLA Antigens