Kidney preservation.

1. Machine preservation yielded better early graft function than simple cold storage of cadaver donor kidneys with more than 24 hours of CIT. However, there was no difference in one-year graft survival rates comparing machine and cold storage preservation regardless of CIT. 2. The percentage of kidneys that functioned immediately posttransplant progressively decreased from 65% with up to 5 minutes WIT to 45% with more than 20 minutes WIT. One-year graft survival rates fell from 80% with zero WIT to 72% with more than 20 minutes WIT. There was no clear effect of WIT in regrafted patients. 3. Although CIT had no apparent effect on one-year graft survival, the rate of graft loss after the first year was nearly double for kidneys with more than 48 hours CIT. This long-term effect of CIT was evident whether all patients transplanted since 1976 were considered or only CsA-treated patients. The increase in late graft loss was evident in kidneys stored more than 36 hours if the recipient received CsA.