Introduction: Multiple factors in organ retrieval and transplantation influence the short-and long-term renal allograft outcome. Donor In Situ Ischaemia Time (DISIT) is the time from commencement of cold perfusion in the deceased donor, until the organ is removed and placed within ice. We studied the association between DISIT and short time graft function in kidney transplant recipients.

Methods: Using data from 540 consecutive kidney transplants between 1st of January 2014 and 1st of January 2022, we assessed the association between DISIT and graft function post-transplant using a multivariable ordinal logistic regression, adjusted for DCD status, donor sex and age, and KDPI. We defined graft function as immediate, slow graft and delayed graft function. In a subset of our cohort, n = 47, histological assessment (cv score – Banff criteria for chronic vasculitis) of the allograft was assessed using a linear regression.

Results: The mean age (SD) of the transplant recipient was 51.69 (12.89), with median DISIT time of 34 minutes. For every one-minute increase in the DISIT, odds of developing slow graft function and delayed graft function versus immediate graft function is 3.3 times higher, given all other variables are held constant. the DISIT correlated significantly with initial renal allograft function (p<0.05).  Further, DISIT was also correlated with an increase in cv score during the first 12-months post-transplantation (p<0.01).

Conclusion: These results demonstrate the importance of minimising this novel ischaemia time as a way of reducing the incidence of short- and long-term graft injury.