title: Outcomes of kidney paired donation transplants in relation to shipping and cold ischaemia time.
abstract: To assess the impact of shipping distance and cold ischaemia time (CIT) of shipped organs in a kidney paired donation (KPD) programme, we evaluated the outcomes of the initial 100 kidney transplants performed in the Australian KPD programme. In a 44-month period, 12 centres were involved in fifteen 2-way, twenty 3-way, one 4-way and one 6-way exchanges. Sixteen kidneys were transplanted at the same hospital (CIT 2.6 ± 0.6 h) and 84 required transport to the recipient hospital (CIT 6.8 ± 2.8 h). A spontaneous fall in serum creatinine by at least 10% within 24 h was observed in 85% of recipients, with no difference between nonshipped and shipped kidneys. There were two cases of transient delayed graft function requiring dialysis and patient and graft survival at 1 year were 99% and 97%, respectively. There was no difference in recipients of nonshipped compared with shipped kidneys with regard to serum creatinine at 1 month (mean difference (MD) 7.3 μmol/l, 95% CI -20.2 to 34.8, P = 0.59), 1-year graft survival (MD 3.9%, 95% CI -5.4 to 13.2, P = 0.41) or patient survival (MD -2.4%, 95% CI -10.0 to 5.2, P = 0.54). Despite prolonged CIT for interstate exchanges, the programme's decision to ship donor kidneys rather than the donor appears to be safe.
authors.affiliation: Department of Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia.|Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Allen
authors.affiliation: Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.|Department of Surgery, Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Pleass
authors.affiliation: Australia and New Zealand Dialysis and Transplant Registry, University of Adelaide at Central Northern Adelaide Renal & Transplant Services, Adelaide, SA, Australia.
authors.forename: Phil A
authors.initials: PA
authors.lastname: Clayton
authors.affiliation: Department of Nephrology and Transplantation, Prince of Wales Hospital, Sydney, NSW, Australia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Woodroffe
authors.affiliation: Department of Nephrology and Transplantation, Prince of Wales Hospital, Sydney, NSW, Australia.|Clinical School, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ferrari
mesh_terms: D000368:Aged; D001315:Australia; D050377:Cold Ischemia; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D012042:Registries; D051437:Renal Insufficiency / Q000601:surgery*; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003404:Creatinine
keywords: cold ischaemia time; delayed graft function; kidney paired donation; living-donor kidney transplantation; organ transport