Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011

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dc.contributor.authorKoizumi, Naoru
dc.contributor.authorDasGupta, Debasree
dc.contributor.authorPatel, Amit V.
dc.contributor.authorSmith, Tony
dc.contributor.authorMayer, Jeremy D.
dc.contributor.authorCallender, Clive
dc.contributor.authorMelancon, Joseph K.
dc.date.accessioned2016-08-09T00:26:07Z
dc.date.available2016-08-09T00:26:07Z
dc.date.issued2015-08-13
dc.description.abstractBackground: Regional variations in kidney and liver transplant outcomes have been reported, but their causes remain largely unknown. This study investigated variations in kidney and liver cold ischemia times (CITs) across organ procurement organizations (OPO) as potential causes of variations in transplant outcomes. Methods: This retrospective study analyzed the Standard Transplant Analysis and Research data of deceased donor kidney (n = 61,335) and liver (n = 39,285) transplants performed between 2003 and 2011. The CIT variations between the 2 types of organs were examined and compared. Factors associated with CIT were explored using multivariable regressions. Spearman rank tests were used to associate CIT with graft failure at the OPO level. Results: Significant CIT variations were found across OPOs for both organs (P < 0.05). The variation was particularly large for kidney CIT. Those OPOs with longer average kidney CIT were likely to have a lower graft survival rate (P = 0.01). For liver, this association was insignificant (P = 0.23). The regression analysis revealed sharp contrasts between the factors associated with kidney and liver CITs. High-risk kidney transplant recipients and marginal kidneys were associated with longer average CIT. The reverse was true for liver transplants. Conclusions: Large variations in kidney CIT compared to liver CIT may indicate that there is a room to reduce kidney CIT. Reducing kidney CIT through managerial improvements could be a cost-effective way to improve the current transplant system.
dc.description.sponsorshipPublication of this article was funded in part by the George Mason University Libraries Open Access Publishing Fund.
dc.identifier.citationKoizumi, Naoru, Debasree DasGupta, Amit V. Patel, Tony E. Smith, Jeremy D. Mayer, Clive Callender, and Joseph K. Melancon. “Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011.” Transplantation Direct 1, no. 7 (August 2015): e27. doi:10.1097/TXD.0000000000000529.
dc.identifier.doihttp://dx.doi.org/10.1097/TXD.0000000000000529
dc.identifier.urihttps://hdl.handle.net/1920/10337
dc.language.isoen_US
dc.publisherWolters Kluwer
dc.subjectKidney and liver transplant
dc.subjectCold ischemia times
dc.subjectOrgan procurement organizations
dc.subjectTransplant outcomes
dc.titleGeographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011
dc.typeArticle

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