Prolonged Cold Ischemia Time Obviates the Benefits of 0 HLA Mismatches in Renal Transplantation

HYPOTHESIS Recipients of 0 HLA mismatch kidneys with prolonged cold ischemia times of longer than 36 hours do not have superior outcomes compared with recipients of kidneys with 1 or more mismatches. DESIGN Retrospective review. SETTING Transplanation centers. PATIENTS AND METHODS A total of 63,688 recipients who underwent transplantation between January 1, 1990, and July 31, 1998. MAIN OUTCOME MEASURES Delayed graft function, serum creatinine level, and patient and renal graft survival. RESULTS Recipients of 0 HLA mismatch kidneys with fewer than 36 hours of cold ischemia time had better 5-year graft survival (75%) when compared with recipients with 1 or more mismatches (67%) (P