The Semi-Elective Transplant Initiative (SETI) redesigned transplant operations for deceased-donor kidneys, integrating advanced preservation and morning OR scheduling.
Cold ischemia time increased modestly and use of machine perfusion expanded, enabling transplantation of more logistics-sensitive grafts including high-risk DCD kidneys.
Transplant timing shifted to predictable morning slots (8-10 AM), transforming a historically reactive process into a proactive, manageable workflow.
No significant differences in delayed graft function or graft failure were observed, indicating safety despite logistical changes, although analysis was underpowered to confirm equivalence.
