1089 Factors That Influence Cold Ischaemia Time in Deceased Donor Simultaneous Pancreas and Kidney Transplants: Results of a National Transplant Access to Theatre (NTACT) Audit

Aim Various factors prolong cold ischaemia time (CIT) during simultaneous deceased donor pancreas and kidney (SPK) utilisation across the UK, impacting graft survival. However, there is a lack of data on these obstacles; therefore, this multicentre national audit aims to identify the factors that occur between the organs’ arrival at the implanting centre and transplantation. Method A prospective audit examining adult deceased donor SPK transplants across five UK transplant centres from February to September 2022. Precise time intervals between pre-transplantation checkpoints and perceived reasons for delays post-arrival at the implanting centre were recorded on RedCap platform. Descriptive statistics were used for analysis. Results Data from 29 SPK transplants were collected, with five exclusions for incomplete/incorrect data. Among these, 12 involved donations after brainstem death (DBD) organs and 12 donations after circulatory death organs (DCD). Median CIT for DBD kidneys and pancreas were 12:08 (IQR: 10:45-12:59) and 10:13 (IQR: 8:28-10:33), respectively. For DCD organs, corresponding figures were 10:30 (IQR: 09:13-12:17) and 07:44 (IQR:07:12-09:37). 17% of DCD and 0% of DBD pancreas and 17% of DCD and 4% DBD kidneys exceeded national CIT recommendations. Median times from organ arrival to knife to skin, warm ischemia (WIT) for pancreases, and patient arrival at the theatre were 03:17 (IQR: 03:00-03:48), 00:38 (IQR 00:31-00:43), and 01:41 (IQR: 00:52-01:57), respectively. Delays were reported in 96% of transplants. Conclusions This audit highlights significant proportions of organs exceeding national CIT cut-offs and identifies delays in organ utilisation requiring improvement.