» Articles » PMID: 35329945

The Impact of Cold Ischaemia Time on Outcomes of Living Donor Kidney Transplantation: A Systematic Review and Meta-Analysis

Overview
Journal J Clin Med
Specialty General Medicine
Date 2022 Mar 25
PMID 35329945
Authors
Affiliations
Soon will be listed here.
Abstract

Studies have been carried out to investigate the effect of a prolonged cold ischaemia time (CIT) on the outcomes of living donor kidney transplantation (LDKT). There is no clear consensus in the literature about the effects of CIT on LDKT outcomes, and therefore, we performed a systematic review and meta-analysis to provide evidence on this subject. Searches were performed in five databases up to 12 July 2021. Articles comparing different CIT in LDKT describing delayed graft function (DGF), graft and patient survival, and acute rejection were considered for inclusion. This study is registered with PROSPERO, CRD42019131438. In total, 1452 articles were found, of which eight were finally eligible, including a total of 164,179 patients. Meta-analyses showed significantly lower incidence of DGF (odds ratio (OR) = 0.61, p < 0.01), and significantly higher 1-year graft survival (OR = 0.72, p < 0.001) and 5-year graft survival (OR = 0.88, p = 0.04), for CIT of less than 4 h. Our results underline the need to keep CIT as short as possible in LDKT (ideally < 4 h), as a shorter CIT in LDKT is associated with a statistically significant lower incidence of DGF and higher graft survival compared to a prolonged CIT. However, clinical impact seems limited, and therefore, in LDKT programmes in which the CIT might be prolonged, such as kidney exchange programmes, the benefits outweigh the risks. To minimize these risks, it is worth considering including CIT in kidney allocation algorithms and in general take precautions to protect high risk donor/recipient combinations.

Citing Articles

Favorable Living Donor Kidney Transplantation Outcomes within a National Kidney Exchange Program: A Propensity Score-Matching Analysis.

van de Laar S, de Weerd A, Bemelman F, Idu M, de Vries A, Alwayn I Clin J Am Soc Nephrol. 2025; 20(3):440-450.

PMID: 39879095 PMC: 11906000. DOI: 10.2215/CJN.0000000611.


Mitigating High-risk EBV and CMV Through Kidney Paired Donation: A Survey of Potential Donor and Recipient Candidates.

Kalaria A, Mehta R, Sood P, Zhang X, Morford H, Potluri V Transplant Direct. 2024; 10(12):e1737.

PMID: 39563724 PMC: 11576024. DOI: 10.1097/TXD.0000000000001737.


Clean Intermittent Catheterization in Children under 12 Years Does Not Have a Negative Impact on Long-Term Graft Survival following Pediatric Kidney Transplantation.

Marcou M, Galiano M, Tzschoppe A, Sauerstein K, Wach S, Taubert H J Clin Med. 2024; 13(1).

PMID: 38202040 PMC: 10779672. DOI: 10.3390/jcm13010033.


Prompt Thrombo-Inflammatory Response to Ischemia-Reperfusion Injury and Kidney Transplant Outcomes.

Strandberg G, Oberg C, Blom A, Slivca O, Berglund D, Segelmark M Kidney Int Rep. 2023; 8(12):2592-2602.

PMID: 38106604 PMC: 10719603. DOI: 10.1016/j.ekir.2023.09.025.


Risk Factor Analysis for Long-Term Graft Survival Following Pediatric Kidney Transplantation: The Importance of Pretransplantation Time on Dialysis and Donor/Recipient Age Difference.

Marcou M, Galiano M, Tzschoppe A, Sauerstein K, Wach S, Taubert H J Clin Med. 2023; 12(22).

PMID: 38002629 PMC: 10672108. DOI: 10.3390/jcm12227014.

References
1.
Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

2.
Doshi M, Garg N, Reese P, Parikh C . Recipient risk factors associated with delayed graft function: a paired kidney analysis. Transplantation. 2011; 91(6):666-71. DOI: 10.1097/TP.0b013e318209f22b. View

3.
Segev D, Veale J, Berger J, Hiller J, Hanto R, Leeser D . Transporting live donor kidneys for kidney paired donation: initial national results. Am J Transplant. 2011; 11(2):356-60. DOI: 10.1111/j.1600-6143.2010.03386.x. View

4.
van Dellen D, Burnapp L, Citterio F, Mamode N, Moorlock G, Van Assche K . Pre-emptive live donor kidney transplantation-moving barriers to opportunities: An ethical, legal and psychological aspects of organ transplantation view. World J Transplant. 2021; 11(4):88-98. PMC: 8058646. DOI: 10.5500/wjt.v11.i4.88. View

5.
Kasiske B, Snyder J, Matas A, Ellison M, Gill J, Kausz A . Preemptive kidney transplantation: the advantage and the advantaged. J Am Soc Nephrol. 2002; 13(5):1358-64. DOI: 10.1097/01.asn.0000013295.11876.c9. View