title: Effect of cold ischaemia time on outcome after living donor renal transplantation.
abstract: BACKGROUND
  The aim of the present study was to determine the effects of cold ischaemia time (CIT) on living donor kidney transplant recipients in a large national data set.
  
  
  METHODS
  Data from the National Health Service Blood and Transplant and UK Renal Registry databases for all patients receiving a living donor kidney transplant in the UK between January 2001 and December 2014 were analysed. Patients were divided into three groups depending on CIT (less than 2 h, 2-4 h, 4-8 h). Risk-adjusted outcomes were assessed by multivariable analysis adjusting for discordance in both donor and recipient characteristics.
  
  
  RESULTS
  Outcomes of 9156 transplants were analysed (CIT less than 2 h in 2662, 2-4 h in 4652, and 4-8 h in 1842). After adjusting for confounders, there was no significant difference in patient survival between CIT groups. Recipients of kidneys with a CIT of 4-8 h had excellent graft outcomes, although these were slightly inferior to outcomes in those with a CIT of less than 2 h, with risk-adjusted rates of delayed graft function of 8·6 versus 4·3 per cent, and 1-year graft survival rates of 96·2 versus 97·1 per cent, respectively.
  
  
  CONCLUSIONS
  The detrimental effect of prolonging CIT for up to 8 h in living donation kidney transplantation is marginal.
authors.affiliation: Departments of Renal Surgery, University Hospital Birmingham NHS Trust, Birmingham, UK.|School of Medical and Dental Science, University of Birmingham, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Nath
authors.affiliation: Departments of Biostatistics, University Hospital Birmingham NHS Trust, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Hodson
authors.affiliation: School of Medical and Dental Science, University of Birmingham, Birmingham, UK.
authors.forename: S W
authors.initials: SW
authors.lastname: Canbilen
authors.affiliation: Departments of Renal Surgery, University Hospital Birmingham NHS Trust, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Al Shakarchi
authors.affiliation: Departments of Renal Surgery, University Hospital Birmingham NHS Trust, Birmingham, UK.
authors.forename: N G
authors.initials: NG
authors.lastname: Inston
authors.affiliation: Departments of Renal Medicine, University Hospital Birmingham NHS Trust, Birmingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sharif
authors.affiliation: Departments of Renal Surgery, University Hospital Birmingham NHS Trust, Birmingham, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Ready
mesh_terms: D000328:Adult; D050377:Cold Ischemia / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009926:Organ Preservation / Q000379:methods*; D017063:Outcome Assessment, Health Care; D012042:Registries; D013997:Time Factors