Limiting cold ischemia times could increase the amount of available kidneys donated after circulatory death (DCD), according to a new study published in the Journal of the American Society of Nephrology. Between 2008 and 2015, 20% of DCD kidneys were discarded, varying from 3% to 33% among donor service areas.

John Gill, MD, MS, from the University of British Columbia and Vancouver’s Providence Health Care, and his colleagues examined national data obtained between 2008 and 2015. The number of DCD kidneys recovered by the country’s 58 donor service areas varied substantially (from 0 to 1,072), and 25% of DCD kidneys were recovered in only four donor service areas.

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DCD kidneys exhibited excellent organ survival, with a 5-year survival rate of 75%. Certain DCD kidneys were at higher risk of failing when compared with kidneys from brain dead donors, but only when the cold ischemia time was >12 hours.

“We found that use of DCD kidneys is variable throughout the United States, that the outcomes are generally excellent, and that the use of these organs could probably be safely increased if cold ischemia times are limited,” said Gill.