Introduction: In renal transplantation, graft survival using organs from deceased donors is inferior to results after living donation. Little however is known about the effect of brain death duration (BDdur) on long term outcome after kidney transplantation (KTx).

Patients and Methods: A single-center retrospective analysis of 1245 consecutive deceased donor KTx, performed between January 2000 and December 2010, was carried out. BDdur was calculated as the period between brain death declaration and start of cold perfusion. All recipient-, donor- and transplant- factors, known at the timepoint of KTx, were investigated for their impact on delayed graft function (DGF), acute rejection (AR), „graft loss“ and „death“. Uni- as well as multivariate statistical analysis were performed using binary logistic- and Cox-regression analysis.

Results: Mean BDdur was 12.01 ± 6.26 hours. DGF was associated with a significantly longer BDdur (12.13 ± 5.815 vs. 11.82 ± 6.177 hours, p=0.0034). Not significant correlation of AR and BDdur was seen (AR 11.85 ± 6.33 hours vs.12.04 ± 5.997 hours no AR, p=0.156). BDdur did not affect long term graft survival, but had a significant impact on patient survival. Apart from recipient´s age, BDdur was the most important independent factor for „death“ after KTx (Hazard Ratio (95%CI): 1.041 (1.015-1.067); p=0.002).

Conclusion: Taken together our results highlight the importance of BDdur as an independent factor negatively influencing long term survival after kidney transplantation. Strategies to optimize time management prior as well as during organ retrieval are essential to improve outcome after kidney transplantation.

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