Predictive Models for the Functional Recovery of Transplanted Kidney.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Dec 2021
Historique:
received: 21 05 2021
revised: 04 08 2021
accepted: 30 08 2021
pubmed: 4 11 2021
medline: 17 12 2021
entrez: 3 11 2021
Statut: ppublish

Résumé

Renal transplantation is the gold standard treatment for end-stage renal disease, however, in 20% of cases, the graft develops a delayed graft function (DGF) that is associated with both early and late worsening of the outcome. The aim of this study was to examine and validate in a population of transplanted patients the appropriateness of the predictive score systems of DGF available to identify patients who might take advantage of a tailored immunosuppressive therapy. We conducted a systematic review of the literature to identify articles concerning scoring systems predicting DGF to identify those applicable to the study population and subsequently comparing their appropriateness for defining the most accurate one. From an analysis of the scientific literature, we found 7 scoring systems predicting DGF. Of these, 3 can be calculated for the study population. We enrolled 247 renal transplants in the study. DGF was recorded in 41 cases (15.95%). The Irish score recognized 25 of 41 cases (60.98%), the Jeldres score 41 of 41 cases (100%), and the Chapal score only 7 of 41 (17.07%). Although the Irish score did not identify all cases of DGF, the analysis of data revealed that it is the most accurate, with area under the receiver operating characteristic almost overlapping. The study resulted in some interesting and promising conclusions about the predictability of DGF, defining the Irish score as the most reliable. This result can be considered the fundamental requirement to develop a custom therapeutic algorithm to be applied to all recipients with higher probability of developing DGF.

Sections du résumé

BACKGROUND BACKGROUND
Renal transplantation is the gold standard treatment for end-stage renal disease, however, in 20% of cases, the graft develops a delayed graft function (DGF) that is associated with both early and late worsening of the outcome. The aim of this study was to examine and validate in a population of transplanted patients the appropriateness of the predictive score systems of DGF available to identify patients who might take advantage of a tailored immunosuppressive therapy.
MATERIALS AND METHODS METHODS
We conducted a systematic review of the literature to identify articles concerning scoring systems predicting DGF to identify those applicable to the study population and subsequently comparing their appropriateness for defining the most accurate one.
RESULTS RESULTS
From an analysis of the scientific literature, we found 7 scoring systems predicting DGF. Of these, 3 can be calculated for the study population. We enrolled 247 renal transplants in the study. DGF was recorded in 41 cases (15.95%). The Irish score recognized 25 of 41 cases (60.98%), the Jeldres score 41 of 41 cases (100%), and the Chapal score only 7 of 41 (17.07%). Although the Irish score did not identify all cases of DGF, the analysis of data revealed that it is the most accurate, with area under the receiver operating characteristic almost overlapping.
CONCLUSIONS CONCLUSIONS
The study resulted in some interesting and promising conclusions about the predictability of DGF, defining the Irish score as the most reliable. This result can be considered the fundamental requirement to develop a custom therapeutic algorithm to be applied to all recipients with higher probability of developing DGF.

Identifiants

pubmed: 34728075
pii: S0041-1345(21)00705-3
doi: 10.1016/j.transproceed.2021.08.053
pii:
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2873-2878

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Giuseppe Ietto (G)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy. Electronic address: giuseppe.ietto@gmail.com.

Luca Guzzetti (L)

Anesthesia and Intensive Care Unit, ASST-Settelaghi and University of Insubria, Varese, Italy.

Cristiano Salvino Baglieri (CS)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Veronica Raveglia (V)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Elia Zani (E)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Fabio Benedetti (F)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Cristiano Parise (C)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Valentina Iori (V)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Caterina Franchi (C)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Federica Masci (F)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Andrea Vigezzi (A)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Enrico Ferri (E)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Domenico Iovino (D)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Linda Liepa (L)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Davide Brusa (D)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Mauro Oltolina (M)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Mattia Gritti (M)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Marta Ripamonti (M)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Daniela Dalla Gasperina (DD)

Infectious Disease Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Andrea Ambrosini (A)

Nephrology Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Francesco Amico (F)

Trauma Service, Department of Surgery, University of Newcastle, Newcastle, Australia.

Salomone Di Saverio (SD)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Gabriele Soldini (G)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Lorenzo Latham (L)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Matteo Tozzi (M)

Vascular Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Giulio Carcano (G)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

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