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Abstract: PO2077

Effect of Cold Ischemia Time on Death-Censored Graft Survival of Post-One-Year Survivor Deceased Donor Kidney Transplant Recipients in the United States

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical


  • Murthy, Bhamidipati V.R., Baylor College of Medicine, Houston, Texas, United States
  • Awan, Ahmed A., Baylor College of Medicine, Houston, Texas, United States
  • Rana, Abbas, Baylor College of Medicine, Houston, Texas, United States
  • Goss, John A., Baylor College of Medicine, Houston, Texas, United States

Prolonged cold ischemia has been associated with increased incidence of delayed graft function and poor short term graft survival among deceased donor allografts. However, the data on long term graft survival is less clear. Our aim was to evaluate long-term graft survival for deceased donor kidney recipients who survived one year after transplantation such that the immediate adverse outcomes do not cloud the long term outcomes


We retrospectively analyzed data from the United Network for Organ Sharing (UNOS) from 1995 to 2017. Living donor transplants, multi-organ transplants, recipients <18 years age at transplantation, and those who died within 1 year of transplantation were excluded. Using multivariable Cox regression analysis, a total of 145,680 recipients were analyzed with death censoring to estimate graft survival with varying cold ischemia times


Compared with cold ischemic time of <5 hours, the graft failure probability steadily increased with increasing cold ischemia time such that the hazards of graft loss were 42% higher with ischemic time greater than 35 hours (Figure 1). Worse graft survival was also observed in males (HR 1.08), increasing donor age beyond 30 years, Blacks (HR 1.77), BMI >30 (HR 1.13), those who had dialysis prior to transplant (HR 1.41), diabetes (HR 1.12), and PRA >90% (HR 1.16). Recipients older than 40 years had a lower graft loss compared to those between 18 and 40 years age.


Prolonged cold ischemia time adversely affects long-term graft survival among deceased donor kidney transplant recipients in the US. The hazards of graft loss appear to be proportional to the duration of cold ischemia time.

Hazards of Graft Loss with Increasing Cold Ischemia Time In Deceased Donor Kidney Allografts


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