24 Cold Ischemia Time Alone Does Not Affect Graft Outcomes: A Big Data Analysis of UK Kidney Transplant Registry - CITGO Study.

The article focuses on a large-scale analysis of factors affecting kidney graft survival using data from the UK Transplant Registry. It examines the combined impact of cold ischemia time (CIT), donor risk index (DRI), human leukocyte antigen (HLA) mismatch, and donor type on graft outcomes in 35,627 adult deceased-donor kidney transplant recipients between 2000 and 2020. The study found that longer CIT, higher DRI, greater HLA mismatch, and donation after circulatory death (DCD) donor type independently increased the risk of graft failure, with significant interactions among these factors. A composite risk score was developed to stratify recipients, showing that prolonged CIT had a more pronounced negative effect on graft survival in DCD compared to donation after brain death (DBD) transplants. The findings suggest that considering multiple interacting factors can improve risk stratification and decision-making in kidney transplantation.