This single-center retrospective review by Alghannam et al. looked at the impact of functional warm ischemic time (fWIT) in controlled DCD donors by comparing donor/recipient characteristics and outcomes between high fWIT (>60min), low fWIT (<60min), and DBD kidneys. Out of 2,811 patients from 2000 to 2021, 638 received low fWIT kidneys, 93 received high fWIT kidneys, and 2,080 received kidneys from DBD donors.

The results showed:

• No significant difference in 5-year graft survival between low fWIT, high fWIT, or DBD groups, despite significantly higher DGF rates in both low and high fWIT groups
• Kidneys with an increase in KDRI and high CIT had higher hazard ratios for 1-year graft failure

The authors noted that they acquired a hypothermic machine perfusion device in 2008 and routinely use it for all DCDs unless deemed unsuitable for logistic or technical reasons, which allowed them early expansion of DCD kidney transplantation.

They concluded that DCD kidneys with fWIT>60 min can be safely transplanted with careful donor and recipient selection and should not be declined solely for fWIT.

Read the entire article here: https://onlinelibrary.wiley.com/doi/10.1111/ctr.15436