cold ischemia


Summary: The chilling of a tissue or organ during decreased BLOOD perfusion or in the absence of blood supply. Cold ischemia time during ORGAN TRANSPLANTATION begins when the organ is cooled with a cold perfusion solution after ORGAN PROCUREMENT surgery, and ends after the tissue reaches physiological temperature during implantation procedures.

Top Publications

  1. Ueki S, Castellaneta A, Yoshida O, Ozaki K, Zhang M, Kimura S, et al. Hepatic B7 homolog 1 expression is essential for controlling cold ischemia/reperfusion injury after mouse liver transplantation. Hepatology. 2011;54:216-28 pubmed publisher
  2. Faleo G, Neto J, Kohmoto J, Tomiyama K, Shimizu H, Takahashi T, et al. Carbon monoxide ameliorates renal cold ischemia-reperfusion injury with an upregulation of vascular endothelial growth factor by activation of hypoxia-inducible factor. Transplantation. 2008;85:1833-40 pubmed publisher
    ..We have previously shown that carbon monoxide (CO) inhalation at a low concentration provides protection against cold ischemia-reperfusion (I/R) injury after kidney transplantation...
  3. Maglione M, Oberhuber R, Cardini B, Watschinger K, Hermann M, Obrist P, et al. Donor pretreatment with tetrahydrobiopterin saves pancreatic isografts from ischemia reperfusion injury in a mouse model. Am J Transplant. 2010;10:2231-40 pubmed publisher
    ..Grafts were subjected to 16 h cold ischemia time (CIT) and different treatment regimens: no treatment, 160 ?M H4B to perfusion solution, H4B 50 mg/kg ..
  4. Zhang M, Ueki S, Kimura S, Yoshida O, Castellaneta A, Ozaki K, et al. Roles of dendritic cells in murine hepatic warm and liver transplantation-induced cold ischemia/reperfusion injury. Hepatology. 2013;57:1585-96 pubmed publisher
    ..Using both warm and cold hepatic IR models, this study suggests differential roles of liver-resident versus blood-borne DC, and points to the importance of the local microenvironment in determining DC function during hepatic IR injury. ..
  5. Schneeberger S, Amberger A, Mandl J, Hautz T, Renz O, Obrist P, et al. Cold ischemia contributes to the development of chronic rejection and mitochondrial injury after cardiac transplantation. Transpl Int. 2010;23:1282-92 pubmed publisher
    Chronic rejection (CR) remains an unsolved hurdle for long-term heart transplant survival. The effect of cold ischemia (CI) on progression of CR and the mechanisms resulting in functional deficit were investigated by studying gene ..
  6. Tanaka M, Mokhtari G, Terry R, Gunawan F, Balsam L, Hoyt G, et al. Prolonged cold ischemia in rat cardiac allografts promotes ischemia-reperfusion injury and the development of graft coronary artery disease in a linear fashion. J Heart Lung Transplant. 2005;24:1906-14 pubmed
    Prolonged cold ischemia is thought to exacerbate ischemia-reperfusion injury and graft coronary artery disease (GCAD)...
  7. Beri A, Lattouf J, Deambros O, Grüll M, Gschwendtner M, Ziegerhofer J, et al. Partial nephrectomy using renal artery perfusion for cold ischemia: functional and oncologic outcomes. J Endourol. 2008;22:1285-90 pubmed publisher
    We present our series on the safety and long-term oncologic and functional outcomes of laparoscopic partial nephrectomy using renal artery perfusion for cold ischemia.
  8. McGlynn L, Stevenson K, Lamb K, Zino S, Brown M, Prina A, et al. Cellular senescence in pretransplant renal biopsies predicts postoperative organ function. Aging Cell. 2009;8:45-51 pubmed publisher
    ..7% ( p = 0.001) at 1 year posttransplant. Thus, these data indicate that allograft biological age is an important novel prognostic determinant for renal transplant outcome. ..
  9. Kayler L, Magliocca J, Zendejas I, Srinivas T, Schold J. Impact of cold ischemia time on graft survival among ECD transplant recipients: a paired kidney analysis. Am J Transplant. 2011;11:2647-56 pubmed publisher
    Delays in expanded criteria donor (ECD) kidney placement increases cold ischemia times (CIT) potentially leading to discard. The effect of increased CIT on ECD kidney transplant outcomes is unknown...

More Information


  1. Yamashiro S, Kuniyoshi Y, Arakaki K, Uezu T, Miyagi K, Koja K. Cardioprotective effects of tetrahydrobiopterin in cold heart preservation after cardiac arrest. Ann Thorac Cardiovasc Surg. 2006;12:95-104 pubmed
    ..Isolated perfused rat hearts were subjected to 4 degrees C cold ischemia and reperfusion...
  2. Franco Gou R, Mosbah I, Serafin A, Abdennebi H, Rosello Catafau J, Peralta C. New preservation strategies for preventing liver grafts against cold ischemia reperfusion injury. J Gastroenterol Hepatol. 2007;22:1120-6 pubmed
    ..The UW-PEG solution, while retaining all the advantages of UW solution, improved hepatic ischemia-reperfusion injury associated with liver transplantation. ..
  3. Wiedemann D, Schneeberger S, Friedl P, Zacharowski K, Wick N, Boesch F, et al. The fibrin-derived peptide Bbeta(15-42) significantly attenuates ischemia-reperfusion injury in a cardiac transplant model. Transplantation. 2010;89:824-9 pubmed
    ..Bbeta(15-42) ameliorates the ischemia-reperfusion injury in transplanted hearts during extended cold ischemia by reduction of infiltrating leukocytes...
  4. Jani A, Epperson E, Martin J, Pacic A, Ljubanovic D, Martin S, et al. Renal protection from prolonged cold ischemia and warm reperfusion in hibernating squirrels. Transplantation. 2011;92:1215-21 pubmed publisher
    We have previously shown that cold ischemia (CI) results in massive increases in caspase-3 activity, tubular apoptosis, and brush border injury (BBI) in mouse kidneys...
  5. Abukora F, Albqami N, Nambirajan T, Ziegerhofer J, Leeb K, Janetschek G. Long-term functional outcome of renal units after laparoscopic nephron-sparing surgery under cold ischemia. J Endourol. 2006;20:790-3 pubmed
    ..We compared the functional outcomes of kidneys treated under warm and cold ischemia. Twelve patients treated with warm ischemia and 14 treated with cold ischemia had renal function investigation ..
  6. Constantinides C, Tyritzis S, Evangelou C, Kyroudi A, Liatsikos E, Karamessinis P, et al. Vascular endothelial growth factor protein expression in a renal ablation rabbit model under prolonged warm and cold ischemia. Am J Nephrol. 2008;28:438-45 pubmed
    ..The rabbits of each group underwent partial nephrectomy under 90 and 60 min of warm and 90 and 120 min of cold ischemia, except for the sham group (S), which served as control...
  7. Song S, Shen X, Tang Y, Wang Z, Guo W, Ding G, et al. Sinomenine pretreatment attenuates cold ischemia/reperfusion injury in rats: the role of heme oxygenase-1. Int Immunopharmacol. 2010;10:679-84 pubmed publisher
    ..Thus, SIN deserves further exploration as a novel agent to attenuate I/R injury. ..
  8. Bonnas C, Specht K, Spleiss O, Froehner S, Dietmann G, Krüger J, et al. Effects of cold ischemia and inflammatory tumor microenvironment on detection of PI3K/AKT and MAPK pathway activation patterns in clinical cancer samples. Int J Cancer. 2012;131:1621-32 pubmed publisher
    ..In contrast to core needle biopsies, surgically resected breast cancer samples showed evidence of severe signal changes comparable to those effects observed in xenograft tumors exposed to controlled ischemia. ..
  9. Mikhalski D, Wissing K, Ghisdal L, Broeders N, Touly M, Hoang A, et al. Cold ischemia is a major determinant of acute rejection and renal graft survival in the modern era of immunosuppression. Transplantation. 2008;85:S3-9 pubmed publisher
    ..of kidney transplant recipients who have received modern immunosuppressive therapy, the respective role of cold ischemia time (CIT) and delayed graft function (DGF) on acute rejection (AR) rates and long-term graft survival...
  10. Lauzier B, Sicard P, Bouchot O, Delemasure S, Menetrier F, Moreau D, et al. After four hours of cold ischemia and cardioplegic protocol, the heart can still be rescued with postconditioning. Transplantation. 2007;84:1474-82 pubmed
    ..It is interesting to note that, in our experimental conditions, the beneficial effects of postconditioning were comparable to those produced by pyruvate. ..
  11. Rogers C, Ghani K, Kumar R, Jeong W, Menon M. Robotic partial nephrectomy with cold ischemia and on-clamp tumor extraction: recapitulating the open approach. Eur Urol. 2013;63:573-8 pubmed publisher
    We describe a reproducible technique for achieving cold ischemia with intraoperative tumor assessment during robotic partial nephrectomy (RPN) that recapitulates the open approach: intracorporeal cooling and extraction (ICE)...
  12. Hara Y, Stolk M, Ringe J, Dehne T, Ladhoff J, Kotsch K, et al. In vivo effect of bone marrow-derived mesenchymal stem cells in a rat kidney transplantation model with prolonged cold ischemia. Transpl Int. 2011;24:1112-23 pubmed publisher
    Brain death and prolonged cold ischemia are major contributors to the poorer long-term outcome of transplants from deceased donor kidney transplants, with an even higher impact if expanded criteria donors ('marginal organs') are used...
  13. Fondevila C, Shen X, Tsuchihashi S, Uchida Y, Freitas M, Ke B, et al. The membrane attack complex (C5b-9) in liver cold ischemia and reperfusion injury. Liver Transpl. 2008;14:1133-41 pubmed publisher
    ..This is the first report using a clinically relevant liver cold ischemia model to show that local MAC inhibition attenuates IRI cascade in OLT recipients.
  14. Simpkins C, Montgomery R, Hawxby A, Locke J, Gentry S, Warren D, et al. Cold ischemia time and allograft outcomes in live donor renal transplantation: is live donor organ transport feasible?. Am J Transplant. 2007;7:99-107 pubmed
    ..While transport of the kidney is an attractive alternative, there is concern that prolonged cold ischemia time (CIT) would diminish the benefits of live donor transplantation (LDTx)...
  15. Defamie V, Laurens M, Patrono D, Devel L, Brault A, Saint Paul M, et al. Matrix metalloproteinase inhibition protects rat livers from prolonged cold ischemia-warm reperfusion injury. Hepatology. 2008;47:177-85 pubmed
    Matrix metalloproteinases (MMPs) have been implicated in the hepatic injury induced after cold ischemia-warm reperfusion (CI-WR), by altering the extracellular matrix (ECM), but their precise role remains unknown...
  16. van der Vliet J, Warlé M, Cheung C, Teerenstra S, Hoitsma A. Influence of prolonged cold ischemia in renal transplantation. Clin Transplant. 2011;25:E612-6 pubmed publisher
    To determine to what extent current cold ischemia times (CITs) affect the results of renal transplantation in the Netherlands...
  17. Zhao H, Watts H, Chong M, Huang H, Tralau Stewart C, Maxwell P, et al. Xenon treatment protects against cold ischemia associated delayed graft function and prolongs graft survival in rats. Am J Transplant. 2013;13:2006-18 pubmed publisher
    ..Our data suggest that xenon treatment attenuates DGF and enhances graft survival. This approach could be translated into clinical practice leading to a considerable improvement in long-term graft survival. ..
  18. Inci I, Erne B, Arni S, Jungraithmayr W, Inci D, Hillinger S, et al. Prevention of primary graft dysfunction in lung transplantation by N-acetylcysteine after prolonged cold ischemia. J Heart Lung Transplant. 2010;29:1293-301 pubmed publisher
    ..03). In this model, donor and recipient treatment with NAC effectively protected the lung from primary graft dysfunction after prolonged cold ischemia.
  19. Zaouali M, Ben Mosbah I, Boncompagni E, Ben Abdennebi H, Mitjavila M, Bartrons R, et al. Hypoxia inducible factor-1alpha accumulation in steatotic liver preservation: role of nitric oxide. World J Gastroenterol. 2010;16:3499-509 pubmed
    ..relevance of hypoxia inducible factor (HIF-1) and nitric oxide (NO) on the preservation of fatty liver against cold ischemia-reperfusion injury (IRI)...
  20. Li X, Deavers M, Guo M, Liu P, Gong Y, Albarracin C, et al. The effect of prolonged cold ischemia time on estrogen receptor immunohistochemistry in breast cancer. Mod Pathol. 2013;26:71-8 pubmed publisher breast tumors, the American Society of Clinical Oncology/College of American Pathologists recommends that cold ischemia time be kept under 1?h. However, data to address the upper threshold of cold ischemia time are limited...
  21. Gajanayake T, Sawitzki B, Matozan K, Korchagina E, Lehmann M, Volk H, et al. Dextran sulfate facilitates anti-CD4 mAb-induced long-term rat cardiac allograft survival after prolonged cold ischemia. Am J Transplant. 2008;8:1151-62 pubmed publisher
    ..In summary, DXS attenuates I/R-induced acute graft injury and facilitates long-term survival in this clinically relevant transplant model. ..
  22. Nakao A, Kaczorowski D, Wang Y, Cardinal J, Buchholz B, Sugimoto R, et al. Amelioration of rat cardiac cold ischemia/reperfusion injury with inhaled hydrogen or carbon monoxide, or both. J Heart Lung Transplant. 2010;29:544-53 pubmed publisher
    ..This study was designed to evaluate the effects of inhaled hydrogen or CO, or both, on cold ischemia/reperfusion (I/R) injury of the myocardium...
  23. Park S, Lee S. Antioxidant and prooxidant properties of ascorbic acid on hepatic dysfunction induced by cold ischemia/reperfusion. Eur J Pharmacol. 2008;580:401-6 pubmed
    ..The bile output was significantly lower after cold ischemia/reperfusion...
  24. Zaouali M, Ben Abdennebi H, Padrissa Altés S, Mahfoudh Boussaid A, Rosello Catafau J. Pharmacological strategies against cold ischemia reperfusion injury. Expert Opin Pharmacother. 2010;11:537-55 pubmed publisher
    ..For longer periods of cold ischemia, the use of such additives becomes insufficient because graft function deteriorates as a result of ischemia...
  25. Geng Q, Romero J, Saini V, Baker T, Picken M, Gamelli R, et al. A subset of 26S proteasomes is activated at critically low ATP concentrations and contributes to myocardial injury during cold ischemia. Biochem Biophys Res Commun. 2009;390:1136-41 pubmed publisher
    Molecular mechanisms leading to myocardial injury during warm or cold ischemia are insufficiently understood...
  26. Wei L, Wedeking A, Buttner R, Kalff J, Tolba R, van Echten Deckert G. A natural tetrahydropyrimidine protects small bowel from cold ischemia and subsequent warm in vitro reperfusion injury. Pathobiology. 2009;76:212-20 pubmed publisher
    ..5-, 6-tetrahydro-2-methyl-4-pyrimidine carboxylic acid (THP) can protect ileal mucosa and muscularis against cold ischemia and subsequent warm in vitro reperfusion injury...
  27. Spitzer A, Lao O, Dick A, Bakthavatsalam R, Halldorson J, Yeh M, et al. The biopsied donor liver: incorporating macrosteatosis into high-risk donor assessment. Liver Transpl. 2010;16:874-84 pubmed publisher
    ..The Donor Risk Index (DRI) lists 7 donor characteristics, together with cold ischemia time and location of the donor, as risk factors for graft failure...
  28. Kaczorowski D, Nakao A, Vallabhaneni R, Mollen K, Sugimoto R, Kohmoto J, et al. Mechanisms of Toll-like receptor 4 (TLR4)-mediated inflammation after cold ischemia/reperfusion in the heart. Transplantation. 2009;87:1455-63 pubmed publisher
    Toll-Like Receptor 4 (TLR4) signaling mediates early inflammation after cold ischemia-reperfusion (I/R)...
  29. Portier B, Wang Z, Downs Kelly E, Rowe J, Patil D, Lanigan C, et al. Delay to formalin fixation 'cold ischemia time': effect on ERBB2 detection by in-situ hybridization and immunohistochemistry. Mod Pathol. 2013;26:1-9 pubmed publisher
    ..According to 2010 updated guidelines, the pre-analytical variable of time to tissue fixation (cold ischemia time) should be kept to <1?h, however, little has been published about cold ischemia time and its ..
  30. von Heesen M, Seibert K, Hülser M, Scheuer C, Wagner M, Menger M, et al. Multidrug donor preconditioning protects steatotic liver grafts against ischemia-reperfusion injury. Am J Surg. 2012;203:168-76 pubmed publisher
    ..we analyzed the effectiveness of a multidrug donor preconditioning (MDDP) procedure to protect SL from cold ischemia-reperfusion injury. Liver steatosis was induced by a high-carbohydrate, fat-free diet...
  31. Gohrbandt B, Fischer S, Warnecke G, Avsar M, Sommer S, Haverich A, et al. Glycine intravenous donor preconditioning is superior to glycine supplementation to low-potassium dextran flush preservation and improves graft function in a large animal lung transplantation model after 24 hours of cold ischemia. J Thorac Cardiovasc Surg. 2006;131:724-9 pubmed
    ..This intriguing approach merits further evaluation with respect to the mechanisms involved and may improve results in clinical lung preservation. ..
  32. Li S, Guan Q, Chen Z, Gleave M, Nguan C, Du C. Reduction of cold ischemia-reperfusion injury by graft-expressing clusterin in heart transplantation. J Heart Lung Transplant. 2011;30:819-26 pubmed publisher
    b>Cold ischemia-reperfusion injury (IRI) is a major factor for early graft dysfunction and is associated with rejection episodes in heart transplantation. Clusterin (CLU) is a cytoprotective protein with chaperone activity...
  33. Wiedemann D, Schachner T, Bonaros N, Dorn M, Andreas M, Kocher A, et al. Impact of cold ischemia on mitochondrial function in porcine hearts and blood vessels. Int J Mol Sci. 2013;14:22042-51 pubmed publisher
    ..saphenous veins, internal-mammary-arteries and aortas of male landrace pigs were harvested and exposed to cold ischemia in either saline or Custodiol-HTK solution...
  34. Quiroga I, McShane P, Koo D, Gray D, Friend P, Fuggle S, et al. Major effects of delayed graft function and cold ischaemia time on renal allograft survival. Nephrol Dial Transplant. 2006;21:1689-96 pubmed
    ..Therefore, in order to improve the long-term survival of renal allografts efforts should focus on limiting CIT and the damage that occurs during this period and on improving our understanding of DGF. ..
  35. Marada T, Zacharovova K, Saudek F. Perfluorocarbon improves post-transplant survival and early kidney function following prolonged cold ischemia. Eur Surg Res. 2010;44:170-8 pubmed publisher
    ..05). We demonstrated for the first time that conservation with TLM significantly improves the outcome of kidney transplantation in a rat model and should therefore be further studied in larger animals. ..
  36. Dutkowski P, Furrer K, Tian Y, Graf R, Clavien P. Novel short-term hypothermic oxygenated perfusion (HOPE) system prevents injury in rat liver graft from non-heart beating donor. Ann Surg. 2006;244:968-76; discussion 976-7 pubmed
    ..After orthotopic liver transplantation, grafts treated by HOPE demonstrated a significant extension on animal survival. We demonstrate a beneficial effect of HOPE by preventing reperfusion injury in a clinically relevant NHBD model. ..
  37. Massie A, Stewart D, Dagher N, Montgomery R, Desai N, Segev D. Center-level patterns of indicated willingness to and actual acceptance of marginal kidneys. Am J Transplant. 2010;10:2472-80 pubmed publisher
    ..We found 7373 surplus offers (7.1% of all offers), concentrated among a small number of centers. The organ acceptance criteria system is currently underutilized, leading to possibly avoidable inefficiencies in organ distribution. ..
  38. Botha J, Thompson E, Gilroy R, Grant W, Mukherjee S, Lyden E, et al. Mild donor liver steatosis has no impact on hepatitis C virus fibrosis progression following liver transplantation. Liver Int. 2007;27:758-63 pubmed
    ..Mild-moderate donor liver macrovesicular steatosis has no impact on HCV recurrence after liver transplantation for HCV-related cirrhosis. Cold ischaemia time and donor age increased the likelihood of HCV recurrence. ..
  39. Rendal Vázquez M, Díaz Román T, Rodríguez Cabarcos M, Zavanella Botta C, Domenech García N, González Cuesta M, et al. Apoptosis in fresh and cryopreserved cardiac valves of pig samples. Cell Tissue Bank. 2008;9:101-7 pubmed publisher
    ..In summary, the viability of the valves in the case of ischemic times of 2 h, 24 h or after cryopreservation/thawing differs slightly. The death of the cells is mainly mediated by necrosis and not by apoptosis. ..
  40. Gioviale M, Damiano G, Palumbo V, Bellavia M, Cacciabaudo F, Cassata G, et al. Pancreatic islets from non-heart-beating donor pig: two-layer preservation method in an in vitro porcine model. Int J Artif Organs. 2011;34:519-25 pubmed publisher
    ..TLM solution for NHBDs porcine pancreata with cold ischemia time lower than 4 h offers significant advantages over UW solution storage, thereby increasing the isolation ..
  41. Mir M, Campbell R, Sharma N, Remer E, Simmons M, Li J, et al. Parenchymal volume preservation and ischemia during partial nephrectomy: functional and volumetric analysis. Urology. 2013;82:263-8 pubmed publisher
    ..Median age was 61 years, median tumor size 3.5 cm, and median RENAL nephrometry score 8. Median cold ischemia time was 28 minutes and median warm ischemia time 21 minutes...
  42. Botha P. Extended donor criteria in lung transplantation. Curr Opin Organ Transplant. 2009;14:206-10 pubmed
  43. Benck U, Gottmann U, Hoeger S, Lammert A, Rose D, Boesebeck D, et al. Donor desmopressin is associated with superior graft survival after kidney transplantation. Transplantation. 2011;92:1252-8 pubmed publisher
    ..7% vs. 84.8%, P=0.37) abrogated the survival advantage. Donor DDAVP seems to improve renal allograft survival. Combined use of donor DDAVP and low-dose dopamine should receive further evaluation. ..
  44. Lznerowicz A, Chudoba P, Kaminska D, Koscielska Kasprzak K, Drulis Fajdasz D, Hałoń A, et al. Duration of brain death and cold ischemia time, but not warm ischemia time, increases expression of genes associated with apoptosis in transplanted kidneys from deceased donors. Transplant Proc. 2011;43:2887-90 pubmed publisher
    ..core biopsies were performed: biopsy 1--5 minutes before organ perfusion in the donor; biopsy 2--at the end of cold ischemia before kidney implantation; and biopsy 3--30 minutes after reperfusion...
  45. Farney A, Hines M, Al Geizawi S, Rogers J, Stratta R. Lessons learned from a single center's experience with 134 donation after cardiac death donor kidney transplants. J Am Coll Surg. 2011;212:440-51; discussion 451-3 pubmed publisher
    ..Kidneys from DCD SCDs have excellent medium-term outcomes and represent an important means of expanding the donor pool. Kidneys from DCD ECDs have inferior outcomes. ..
  46. Abboud I, Antoine C, Gaudez F, Fieux F, Lefaucheur C, Pillebout E, et al. Pulsatile perfusion preservation for expanded-criteria donors kidneys: Impact on delayed graft function rate. Int J Artif Organs. 2011;34:513-8 pubmed publisher
    ..We conducted a prospective controlled study aiming to evaluate the impact of pulsatile perfusion preservation (PPP) on DGF rate...
  47. Durand F, Renz J, Alkofer B, Burra P, Clavien P, Porte R, et al. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation. Liver Transpl. 2008;14:1694-707 pubmed publisher
    ..Updated data concerning the risks associated with different donor variables in different recipient populations are given. Recommendations on how to safely expand donor selection criteria are proposed. ..
  48. Wang G, Hu B, Li Z. Cold ischemia/reperfusion injury in a mouse model of partial liver transplantation. J Surg Res. 2013;181:337-41 pubmed publisher
    ..The aim of this study was to develop a model of cold ischemia/reperfusion injury in mouse partial liver transplantation...
  49. Fonouni H, Jarahian P, Rad M, Golriz M, Faridar A, Esmaeilzadeh M, et al. Evaluating the effects of extended cold ischemia on interstitial metabolite in grafts in kidney transplantation using microdialysis. Langenbecks Arch Surg. 2013;398:87-97 pubmed publisher
    During kidney transplantation (KTx), the length of cold ischemia time (CIT) and the subsequent changes in energy metabolism may lead to variations in interstitial metabolites...
  50. Moussavian M, Scheuer C, Schmidt M, Kollmar O, Wagner M, von Heesen M, et al. Multidrug donor preconditioning prevents cold liver preservation and reperfusion injury. Langenbecks Arch Surg. 2011;396:231-41 pubmed publisher
    ..model whether a multidrug donor preconditioning (MDDP) can not only reduce but also completely prevent cold ischemia-reperfusion injury...
  51. Pérez Valdivia M, Gentil M, Toro M, Cabello M, Rodriguez Benot A, Mazuecos A, et al. Impact of cold ischemia time on initial graft function and survival rates in renal transplants from deceased donors performed in Andalusia. Transplant Proc. 2011;43:2174-6 pubmed publisher
    ..A longer CIT was associated with an increase in IGF independent of the age of both the donor and the recipient. Our data also suggested that CIT influenced patient and graft survival rates. ..
  52. Kaizu T, Ikeda A, Nakao A, Tsung A, Toyokawa H, Ueki S, et al. Protection of transplant-induced hepatic ischemia/reperfusion injury with carbon monoxide via MEK/ERK1/2 pathway downregulation. Am J Physiol Gastrointest Liver Physiol. 2008;294:G236-44 pubmed
    ..the efficacy and molecular mechanisms of exogenously delivered inhaled CO in protecting liver grafts from cold ischemia/reperfusion (I/R) injury associated with liver transplantation...
  53. Fandella A, Pernetti R, Marchiori D, Bertaccini A. The effects of renal ischemia on kidney function in renal cancer conservative surgery. Arch Ital Urol Androl. 2006;78:117-22 pubmed
    ..Artery reclamping should be avoided. Both in warm and cold ischemia, the renal tissue should be perfused by mannitol once the circulation is resumed.