title: Decrease in cold ischemic times as a result of protocol changes of urgent immunogenetic testing during cadaveric kidney transplantation in Hungary.
abstract: BACKGROUND
  Based on national ethics committee permission, the procedure of urgent immunogenetics testing prior to cadaveric kidney transplantation was changed in Hungary from January 1, 2011 allowing HLA typing of the donor and prospective crossmatching using peripheral blood samples from the donor prior to the definitive declaration of brain death. The aim of the current study was to compare key indicators of transplantation primarily cold ischemic time [CIT], between time periods with outcomes.
  
  
  METHODS
  The following indicators were systematically collected prospectively and retrospectively for each deceased heart-beating donor transplantation between January 1, 2010 and October 31, 2010 (n = 114) versus January 1, 2011 and October 31, 2011 (n = 91): CIT for the first and second kidney; laboratory turnaround times (TAT), and time for final preparation of the selected recipient.
  
  
  RESULTS
  As a result of the new procedure, the CIT for the first kidney decreased from 16.5 ± 3.5 to 12.4 ± 3.2 hours (P < .001). Similarly, for the second kidney the parameters were a 19.8 ± 3.4 versus 16.0 ± 3.8 hours (P < .001). As a consequence of more hands-on time in the laboratory, the TAT increased from 5.6 ± 0.8 hours to 7.2 ± 1.1 hours (TAT1) followed by an additional 4.2 ± 1.0 hours (TAT2). We also compared the times necessary for preparation of immunologically suitable recipients for transplantation, namely, 9.5 ± 2.3 hours in the earlier system, increasing to 15.5 ± 4.3 hours during the new procedure.
  
  
  CONCLUSIONS
  As a consequence of the procedural change, the CIT parameter decreased significantly for both kidneys, which may have contributed to improved short-term outcomes of transplantation. The time available for final preparation of selected recipients was increased allowing improvements in CIT.
authors.affiliation: Laboratory of Transplantation Immunogenetics, Hungarian Blood Transfusion Service, Budapest, Hungary. inotai.dora@ovsz.hu
authors.forename: D
authors.initials: D
authors.lastname: Inotai
authors.forename: A
authors.initials: A
authors.lastname: Boros-Major
authors.forename: Z
authors.initials: Z
authors.lastname: Illés
authors.forename: A
authors.initials: A
authors.lastname: Szilvási
authors.forename: G
authors.initials: G
authors.lastname: Nagy
authors.forename: K
authors.initials: K
authors.lastname: Rajczy
authors.forename: R
authors.initials: R
authors.lastname: Chmel
authors.forename: R M
authors.initials: RM
authors.lastname: Langer
authors.forename: A
authors.initials: A
authors.lastname: Tordai
mesh_terms: D002102:Cadaver; D003080:Cold Temperature; D006801:Humans; D006814:Hungary; D007511:Ischemia; D016030:Kidney Transplantation; D009926:Organ Preservation; D011446:Prospective Studies