24 Cold Ischemia Time Alone Does Not Affect Graft Outcomes: A Big Data Analysis of UK Kidney Transplant Registry - CITGO Study

• DOI: 10.1093/bjs/znaf042.014
• Publication Date: 2025-03-12T10:57:22Z
• Authors: Fasiha Arshad; Karthik Nanneboyina; Sanjay Mehra; Hemant Sharma
• Keywords: Affect; Cold ischemia

Abstract Background This study investigated the combined impact of cold ischemia time (CIT), donor risk index (DRI), HLA-mismatch, and type on kidney graft survival using data UK Transplant Registry Data. Methods A retrospective cohort 35,627 adult deceased-donor-kidney-transplant recipients (2000-2020) was conducted. Graft analyzed Kaplan-Meier curves multivariable Cox proportional hazards models. composite-risk-score developed to stratify recipients. Results Median follow-up 6.8 years (IQR: 3.2-11.5). Longer-CIT (HR 1.03 per hour, 95% CI 1.02-1.04, P<0.001), higher DRI 1.45 unit, 1.38-1.52, greater HLA mismatch for ≥3 mismatches vs. 0, 1.34-1.57, donation after circulatory death (DCD) 1.28, 1.20-1.36, P<0.001) were independently associated with increased failure. Significant interactions observed between CIT (P<0.001), HLA-mismatch (P=0.003), (P=0.016). The high-risk group had a 2.68-fold failure (95% 2.44-2.95, compared low-risk group. Prolonged (≥18 hours) in DCD than DBD-transplants 1.51, 1.39-1.64 HR 1.19, 1.12-1.27, both P<0.001). Conclusion demonstrates significant interactive effects CIT, DRI, survival, more pronounced impacts DCD-transplants. composite score may aid stratification decision-making transplantation, highlighting importance considering multiple factors their optimizing allocation post-transplant care.