title: Impact of early lymph node procurement to facilitate histocompatibility testing on long-term cadaveric kidney graft survival.
abstract: BACKGROUND
  Prolonged cold ischemia time (CIT) is a clinically important causes of delayed graft function (DGF) after kidney transplantation. As DGF has been previously shown to have a deleterious influence on long-term graft survival, in the present study we analyzed the impact of early lymph node (LN) procurement on CIT, HLA mismatches, and long-term kidney graft outcome.
  
  
  METHODS
  We evaluated 394 consecutive cadaveric procedures performed from 2001 to 2006, including 289 recipients, in whom LN were obtained before kidney procurement seeking to shorten the total time for HLA typing and crossmatch procedures.
  
  
  RESULTS
  During 58±6 months, 24 patients died (918 [8.3%] in the early and 6 [5.7%] in late procurement group, P=ns) and 52 lost their kidney grafts (31 [10.7%] vs 21 [20%]; P=.025). Early procurement of LN performed in 73.4% of all kidney graft recipients shortened CIT by almost 7 hours (22.9 vs 16.1 hours; P<.001), with a nonsignificantly lower incidence of DGF (32.2% vs 41.0%; P=.13). However, a Cox proportional hazards regression model revealed that early procurement reduced the risk of death-censored kidney graft loss by roughly 40% (log-rank, P=.013).
  
  
  CONCLUSIONS
  Early LN procurement in significantly shorten CIT and subsequently reduced the risk of long-term kidney graft loss.
authors: Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland. uryniusz@wp.pl
authors: A
authors: A
authors: Kolonko
authors: J
authors: J
authors: Ziaja
authors: R
authors: R
authors: Król
authors: J
authors: J
authors: Chudek
authors: S
authors: S
authors: Sekta
authors: U
authors: U
authors: Siekiera
authors: L
authors: L
authors: Cierpka
authors: A
authors: A
authors: Wiecek
mesh_terms: D000328:Adult; D002102:Cadaver; D005260:Female; D006085:Graft Survival; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008198:Lymph Nodes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*