Influence of cold ischemia time on the outcome of kidney transplants from donors aged 70 years and above – A Collaborative Transplant Study Report

BACKGROUND The use of kidney allografts from ≥70-year-old donors has increased persistently over the last twenty years. Prolonged cold ischemia time (CIT) is well known to increase graft failure risk. However, despite their growing importance, no data is available on the impact of CIT specifically on survival of allografts from ≥70-year-old donors. METHODS 47,585 kidney transplantations from expanded criteria donors (ECDs) performed during 2000-2017 and reported to the Collaborative Transplant Study were analysed. The impact of CIT on five-year death-censored graft and patient survival was studied for transplantations from 18 hours was stronger in >65-year-old recipients and for transplants with multiple HLA mismatches. The influence of CIT on patient survival was less pronounced. CONCLUSIONS CIT, as long it is kept ≤18 hours, has no significant impact on survival of kidney transplants even from ≥70-year-old ECDs.