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Crystine M. Lee, MD; Jonathan T. Carter; Edward J. Alfrey, MD; Nancy L. Ascher, MD, PhD; John P. Roberts, MD; Chris E. Freise, MD

Arch Surg. 2000;135:1016-1019.

Hypothesis  Recipients of 0 HLA mismatch kidneys with prolonged cold ischemia times of longer than 36 hours do not have superior outcomes compared with recipients of kidneys with 1 or more mismatches.

Design  Retrospective review.

Setting  Transplanation centers.

Patients and Methods  A total of 63,688 recipients who underwent transplantation between January 1, 1990, and July 31, 1998.

Main Outcome Measures  Delayed graft function, serum creatinine level, and patient and renal graft survival.

Results  Recipients of 0 HLA mismatch kidneys with fewer than 36 hours of cold ischemia time had better 5-year graft survival (75%) when compared with recipients with 1 or more mismatches (67%) (P<.001). However, recipients of 0 HLA mismatch kidneys with longer than 36 hours of cold ischemia time did not have any graft survival advantage (71% in 0 HLA mismatch kidneys vs 72% in 1 or more mismatches, P = .24).

Conclusions  Cold ischemia times of longer than 36 hours obviate the benefits of better graft survival conferred by better matching.

From the Department of Surgery, University of California–San Francisco, (Drs Lee, Ascher, Roberts, and Freise); Stanford School of Medicine (Mr Carter) and the Department of Surgery (Dr Alfrey), Stanford University, Stanford, Calif. The authors have no commercial, proprietary, or financial interest in the products and companies described in this article.

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