Correlation of Warm and Cold Ischemic Time to Graft Function in Kidney Transplant: A Single Centre Report

Abstract

Kidney transplantation has been known as a major advancement of modern medicine which provides high-quality life years to patients with irreversible kidney failure (end-stage renal disease, ESRD) worldwide. The first kidney transplantation in Semarang was carried out at Telogorejo Hospital in 1985. Dr. Kariadi Hospital, has also undertaken kidney transplantation 28 times since January 2014 until September 2018. Kidney ischemic time is one of the most important factors which can affect the outcome of kidney transplantation. Prolonged ischemia of the graft can be related to transplantation’s effects. This study aimed to evaluate the influence of warm and cold ischemic time on the outcome of kidney transplantation in Dr. Kariadi Hospital Semarang. This is an observational, cross-sectional study. The data was collected from medical record of all patients who underwent kidney transplantation from January 2014 until December 2018 and the level of creatinine and urine production before and after transplantation was documented. A total of 28 patients were registered and completed the inclusion criteria. The results of the study were tabulated and statistical analysis was performed using SPSS 23.0. The relationship was declared meaningful if p = 0.05 was obtained. From the analysis of the research that has been done using the Pearson correlation test and hypothesis test Wilcoxon, it was found that there was a relationship between ischemic time and a decrease in creatinine level from r = -0.4489 with a value of p = 0.008. From the analysis of the research, a relationship between ischemic time and urine production was found after transplantation with a value of r = -0.562 and a value of p = 0.002. The results of this study show a strong correlation between the length of total ischemic time with a decrease in creatinine and urine production which means that the longer ischemic time, the lower the decrease in creatinine levels and the lesser the urine production.