title: [Is there a safe cold ischemia time interval for the renal graft?].
abstract: OBJECTIVE
  It is aimed to characterize the true relationship of the cold ischemia time (CIT) with graft survival and with the principal post-transplantation events.
  
  
  METHODS
  We analyzed 378 kidney transplants, studying the relationship of the CIT with graft survival using a univariate analysis according to the COX model and seeking the optimum cutoff according to the Kaplan-Meier method and log-rank test. The relationship between CIT and the principal events of the post-transplant was studied using the binary logistic regression.
  
  
  RESULTS
  The mean follow-up of all the group was 77.8 months (± 51 SD) and the mean CIT was 14.8 hours (± 5.1 SD). The univariate analysis revealed that the CIT was not related with the graft survival as a continuous variable (OR=1.04; 95% CI: 0.9-1.08; p>0.05). On establishing the cutoff at 18 hours, we found differences in the actuarial survival. Survival at 5 years was 91% with CIT < 18 h versus 84% with CIT >18 h. Each hour of cold ischemia increased risk of delay in the graft function by 10% (OR=1.1; 95% CI: 1.05-1.15; p<0.001) and also conditioned a greater incidence of acute rejection (41.5% vs. 55.3%; p=0.02) and less time to the first rejection episode (72.6 days±137 vs. 272.2 days±614.8; p=0.023) after 18 hours. The CIT did not seem to be related (p<0.05) with the rest of the post-transplantation events, such as surgical complications or hospital admissions.
  
  
  CONCLUSIONS
  In our experience, cold ischemia under 18 hours does not seem to negatively affect graft survival.
authors.affiliation: Departamento de Urología, Clínica Universidad de Navarra, España. javiferbar@hotmail.com
authors.forename: J
authors.initials: J
authors.lastname: Barba
authors.forename: J J
authors.initials: JJ
authors.lastname: Zudaire
authors.forename: J E
authors.initials: JE
authors.lastname: Robles
authors.forename: A
authors.initials: A
authors.lastname: Tienza
authors.forename: D
authors.initials: D
authors.lastname: Rosell
authors.forename: J M
authors.initials: JM
authors.lastname: Berián
authors.forename: I
authors.initials: I
authors.lastname: Pascual
mesh_terms: D050377:Cold Ischemia / Q000379:methods*; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged