The influence of transportation on cold ischaemia time following deceased-donor kidney transplantation

FOLLOWING DECEASED-DONOR KIDNEY TRANSPLANTATION James Blackmur , Sussie Shrestha , Matthew Boal , Phil Dyer , Lorna Marson . University of Edinburgh, Edinburgh, UK; University of Bristol, Bristol, UK; 3 Scottish National Blood Transfusion Service, Royal Infirmary of Edinburgh, UK; 4 Transplant Unit, Royal Infirmary Edinburgh, Edinburgh, UK. Introduction: Deceased donor kidneys are exchanged between centres in the UK according to HLA matching, length of waiting time and age match of recipient. A prolonged cold ischaemia time (CIT) is associated with poorer outcomes following kidney transplantation. The impact of transportation on CIT has not been fully analysed. Methods: Data were collected prospectively from UK H&I laboratories, transplant centres and from the Transplant Registry between June 2011 and July 2012. Results: Mean CIT in the 1649 kidney transplants identified was 13.9hrs. 7 centres transplanted 50 or fewer kidneys. There was a significant difference in mean CIT between centres (p<0.01, range: 11.5-19.4hrs). Any travel between donor hospital and recipient centre increasedmean CIT by 1.3hrs. Travel over 100miles was associated with an increase in mean CIT by 2.2hrs (p<0.001), and inter-regional transfer with an increase by 2.0hrs(p<0.001). 3% of kidneys were reallocated, with an associated increase in mean CIT by 5.0hrs. Reallocation outwith the same centre increasedmean CIT by 6.7hrs. Air travel appeared to be able to compensate for some of the negative impact of long-distance travel on CIT. Conclusions: Organs should be preferentially allocated to recipient centres within 100miles and within the same region. Air travel should be used for distant transfer.