...kidney paired donation... in relation to shipping and cold ischaemia time

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/tri.12719/abstract?campaign=woletoc

Original Article
Outcomes of kidney paired donation transplants in relation to shipping and cold ischaemia time
      Richard Allen1,2, Henry Pleass2,3, Phil A. Clayton4, Claudia Woodroffe5 andPaolo Ferrari5,6,*
Article first published online: 22 DEC 2015
DOI: 10.1111/tri.12719

Transplant International
Volume 29, Issue 4, pages 425–431, April 2016

Summary
To assess the impact of shipping distance and cold ischaemia time (CIT) of shipped organs in a kidney paired donation (KPD) programme, we evaluated the outcomes of the initial 100 kidney transplants performed in the Australian KPD programme. In a 44-month period, 12 centres were involved in fifteen 2-way, twenty 3-way, one 4-way and one 6-way exchanges. Sixteen kidneys were transplanted at the same hospital (CIT 2.6 ± 0.6 h) and 84 required transport to the recipient hospital (CIT 6.8 ± 2.8 h). A spontaneous fall in serum creatinine by at least 10% within 24 h was observed in 85% of recipients, with no difference between nonshipped and shipped kidneys. There were two cases of transient delayed graft function requiring dialysis and patient and graft survival at 1 year were 99% and 97%, respectively. There was no difference in recipients of nonshipped compared with shipped kidneys with regard to serum creatinine at 1 month (mean difference (MD) 7.3 μmol/l, 95% CI −20.2 to 34.8, P = 0.59), 1-year graft survival (MD 3.9%, 95% CI −5.4 to 13.2, P = 0.41) or patient survival (MD −2.4%, 95% CI −10.0 to 5.2, P = 0.54). Despite prolonged CIT for interstate exchanges, the programme's decision to ship donor kidneys rather than the donor appears to be safe.