Graft survival of expanded criteria donor (ECD) kidneys does not seem to be affected by increased cold ischemia times, say researchers in the USA. Kayler and co-workers analyzed data from paired ECD kidneys from the Scientific Registry of Transplant Recipients and found that although greater cold ischemia time was associated with an increased risk of delayed graft function, overall rates of graft loss over 8 years were similar in paired recipients with higher and lower cold ischemia times.