[Prospective study of harvest-to-transplant time: proposed organization].
BACKGROUND
The cold ischaemia time of a kidney before transplantation has a negative impact on the risk of acute tubular necrosis and graft survival. This cold ischaemia time can be reduced by a different organization of harvesting, organ distribution and transplantation.


METHODS
Seventy nine organ donor case files from the same hospital were reviewed from reception of the donor until transplantation. 135 renal transplantations, including 60 kidneys and 14 kidney-pancreas transplants were performed on site with organs harvested from these donors. The various phases of harvesting were studied: reception and resuscitation of the patient took 30 hours, and the diagnosis of brain death, information of the families and transfer of the donor to the operating room for harvesting took 11 hours.


RESULTS
The mean cold ischaemia time was 6 hours when kidney-pancreas transplantation was performed and 22 hours 30 minutes for isolated local renal transplantation. The decisive factor is the time required to obtain HLA typing, which is only performed during organ harvesting for isolated renal transplantation. HLA typing and lymph node sampling in the intensive care unit would save 7 hours.


CONCLUSIONS
The authors recommend that HLA typing and lymph node sampling for cross matches be performed in the intensive care unit in order to reduce the cold ischaemia time.
Coordination Infirmière, CHU de Bicêtre, Le Kremlin-Bicêtre, France.
Liliane
L
Joseph
Sylvie
S
Thillou
Alain
A
Lefevre
Jacques
J
Duranteau
Pascal
P
Eschwege
Stéphane
S
Droupy
Yacine
Y
Hammoudi
Antoine
A
Durrbach
Gérard
G
Benoît
D000328:Adult; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods; D011446:Prospective Studies; D013997:Time Factors; D020858:Tissue and Organ Harvesting