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Lookup NU author(s): Rania Khattab, Aimen Amer
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Background: Deceased donor kidney transplants often face delays, leading to prolonged cold ischemia time (CIT), yet data on post-allograft arrival delays are scarce. Objectives: This audit aims to identify and characterize the delays contributing to CIT prolongation after allograft arrival at the implanting center. Design: Data was collected prospectively from 14 UK centers between February and September 2022. Timelines from allograft arrival to the implanting center to implantation were recorded for adult deceased donor kidney-only transplants. Results: The median CIT for all 446 allografts [(donation after cardiac death (DCD), 48.2% and donation after brain death (DBD), 51.6%)] was 11:08 h (interquartile range (IQR): 08:15–15:12). A total of 42% of DCD and 15% of DBD allografts exceeded the national recommended duration of 12 and 18 h, respectively. CIT was prolonged in centers with dedicated transplant theaters, with a median CIT of 13:41 (IQR: 08:11–15:13) compared to a median CIT of 09:43 (IQR: 07:36–12:29) hours (p < 0.005, 95% CI: −4.40, −2.60) in centers without dedicated transplant theaters. Compared to full cross-match (FXM) results, a higher proportion of Virtual cross-match (VXM) results (75.2% vs. 89.4%, Odds Ratio (OR): 2.79, CI: 1.57–5.0, p < 0.005) were available before the allograft arrived at the implanting center. The proportion of crossmatch results available before the recipient's arrival at the implanting center was 31.7% (46.6% for VXM vs. 4.9% for FXM, OR: 16.76, CI: 7.50, 44.17, p < 0.005). However, no difference was found in CIT between the VXM (median: 11:06, IQR: 08:14–15:20) and FXM (median: 11:00, IQR: 08:34–14:56) groups (p = 0.75, CI: −0.75, 1.02). Qualitative analysis identified theater and staff unavailability as common reasons for delay. Conclusion: Internal center practices have a significant impact on CIT, necessitating intervention to optimize transplant outcomes.
Author(s): Mujeeb M, Borbas B, Tanase A, Sandhu B, Barnett N, Zakri R, Dabare D, Patel K, Okafor U, Ayorinde T, Chan A, Hanji S, Motallebzadeh R, Alawad A, Brooker V, Chalklin C, Gupta S, Szabo L, Malik A, Mustafa O, Ghazanfar A, Soliman H, Storey R, Petrosius G, Tariq K, Boffa C, Sutaria R, Gopal J, Khambalia H, Moinuddin Z, Prabakaran V, Khattab R, Amer A, Martin L, Houston S, Jackson A, Mayaleh S, Rizzello A, Shankar S, Sinha S, Arachchige S, Konstantinou C, Muhammad K, O'Callaghan J, Hamaoui K, Russel N, Aroori S
Publication type: Article
Publication status: Published
Journal: Clinical Transplantation
Year: 2025
Volume: 39
Issue: 8
Online publication date: 06/08/2025
Acceptance date: 21/06/2025
Date deposited: 20/08/2025
ISSN (print): 0902-0063
ISSN (electronic): 1399-0012
Publisher: John Wiley and Sons Ltd
URL: https://doi.org/10.1111/ctr.70227
DOI: 10.1111/ctr.70227
Data Access Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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