Prolonged warm ischemia time (the time from organ removal from cold storage to reperfusion with warm blood) is associated with graft failure and mortality among kidney transplant recipients. We aimed to identify factors associated with prolonged warm ischemia time in a cohort of deceased donor kidney transplant recipients.

We analyzed a cohort of United States deceased donor kidney transplant recipients (from the Scientific Registry of Transplant Recipients) between 1 Jan 2000 and 30 Jun 2014. Warm ischemia time (the outcome of interest) was categorized as 10-<30 (reference), and ≥30 minutes. Warm ischemia times of <10 minutes were attributed to coding error and excluded. The association between donor, recipient and center factors associated with prolonged warm ischemia time was explored using logistic regression.

Overall, 77,677 patients were included in this study. Donor factors associated with prolonged warm ischemia included expanded versus standard criteria donor status (OR 1.19, 95% CI [1.12-1.26]) and donor history of diabetes (OR 1.14, 95% CI [1.05-1.23]). Recipient body mass index ( ≥35 kg/m² versus 18.5-<25 kg/m², OR 1.45, 95% CI [1.36-1.55]) and previous kidney transplant (OR 1.22, 95% CI [1.15-1.29]) were significantly associated with prolonged warm ischemia time. In contrast, patients from centers with a higher annual transplant volume ( ≥50 transplants/year) had a lower warm ischemia time (OR 0.88, 95% CI [0.85-0.92], table 1).

Donor, recipient and transplant center factors are associated with prolonged warm ischemia time. Acknowledging the association between warm ischemia time and outcome, identifying mechanisms behind these associations and potential therapeutic strategies is an important consideration for future study.

CITATION INFORMATION: Miller A, Kiberd B, Alwayn I, Kim S, Tennankore K. Factors Associated with Prolonged Warm Ischemia Time Among Deceased Donor Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

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