Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Objective: To examine the association between cold ischemia time (CIT) and delayed graft function (DGF) and death-censored graft failure in kidney transplantation.
Methods: To identify relevant articles, the Pubmed database was searched from inception to August 2015. Articles were screened by two independent reviewers. Studies were excluded if they were non-human, non-English, multi-organ, had pediatric recipients, or explicitly mentioned use of machine perfusion. Two independent reviewers extracted data. Only articles that analyzed CIT as a continuous variable were included for analysis.
Results: The Pubmed search yielded 2662 studies of which 271 underwent full review. Given hourly increments in CIT, four studies included adequate data on the hazard of death-censored graft failure (Table 1, Figure 1) and six studies included adequate data on the odds of DGF (Table 2, Figure 1).
Conclusion: Based on the available data in the literature, hourly increments in CIT appear to significantly impact the odds of DGF among renal transplant recipients. However, hourly increments in CIT did not appear to significantly increase the risk of experiencing death-censored graft failure.
Table 1. Relationship between CIT and Death-censored graft failure
|Study||Data Source||Event (N)||Study Size (N)||Hazard Ratio||P-value|
|Hernandez||Single Center (Spain)||184||829||1.04 (1.01, 1.1)||0.021|
|Hwang||Single Center (Korea)||12||195||0.996 (0.989, 1.003)||0.270|
|Debout||Multicenter (France)||449||3839||1.013 (1.001, 1.025)||0.035|
|Chiurchiu||Single Center (Argentina)||56||70||1.03 (0.98, 1.09)||0.100|
Table 2. Relationship between CIT and Delayed graft function
|Study||Data Source||Event (N)||Study Size (N)||Odds Ratio||P-value|
|Premasathian||Registry (Thai TR)||320||756||1.041 (1.025, 1.058)||<0.001|
|Malinoski||Registry (UNOS)||202||722||1.027 (1.006, 1.047)||<0.011|
|Reid||Single Center (UK)||94||190||1.08 (0.95, 1.25)||NS|
|van der Vleit||Registry (Dutch Organ TR)||1163||6322||1.044 (1.034, 1.055)||0.001|
|Ditonno||Single Center (Italy)||241||761||1.0643 (1.0095, 1.1222)||0.02|
|Quiroga||Single Center (UK)||161||518||1.066 (1.041, 1.092)||0.005|
CITATION INFORMATION: Bennett D, Mustafa M, Chiles M, Skillen W, Mohan S. Cold Ischemia Induced Outcomes in Kidney Transplantation: A Meta-Analysis. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Bennett D, Mustafa M, Chiles M, Skillen W, Mohan S. Cold Ischemia Induced Outcomes in Kidney Transplantation: A Meta-Analysis. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/cold-ischemia-induced-outcomes-in-kidney-transplantation-a-meta-analysis/. Accessed March 31, 2020.
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