Impact of changing trend in cold ischaemic time on operating times in renal transplantation.

INTRODUCTION The European Working Time Directive (EWTD) is calling for reduction in the working hours of doctors. Renal transplantation is well-recognised as an out-of-hours specialty. Our study looks at whether our renal transplant centre's attempt to reduce cold ischaemic time (CIT) has impacted on the pattern of operating times since this may have implications on the surgeons' working hours. PATIENTS AND METHODS We studied 883 adult cadaver kidney transplants performed between 1 January 1992 and 31 December 2002. CIT and time of surgery was obtained from a local audit database (www.nwkta.org) and that held by UK Transplant. Time of surgery was divided into 07:30-17:59 (day),18:00-23:59 (evening) and 00:00-07:29 (night). RESULTS CIT has decreased since 1992, with a significant reduction after 1998 (P = 0.0001). There was, however, no difference in the percentage of operations performed during the three time periods before and after 1998. Between 1999-2002, 51.4% of transplants took place out of hours (i.e. 18:00-07:29). CONCLUSIONS Reduction in CIT does not appear to have impacted on our operating times. The large amount of out-of-hours work is, however, not compliant with EWTD requirements.