Delayed Graft Function Duration in Deceased Donor Kidney Transplants.


Journal

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

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 30 12 2021
accepted: 09 02 2022
pubmed: 30 6 2022
medline: 24 8 2022
entrez: 29 6 2022
Statut: ppublish

Résumé

Delayed graft function (DGF) is an important prognostic indicator after kidney transplantation. Depending on the severity of the ischemia-reperfusion injury, DGF can have several clinical presentations, with different renal function recovery times. Both the presence and duration of DGF can have an impact on kidney transplantation outcomes. However, the definition of the cutoff point, above which the outcomes are worse, varies widely in the literature. To investigate the impact of DGF and its duration on patient and graft survivals, a single-center retrospective study including all deceased donor kidney transplants was performed between November 2008 and December 2015 (n = 188). Through the analysis on the receiver operating characteristic curve, the cutoff point that determined the worst outcome was reached. DGF patients were then divided according to the duration of DGF (<8 days or ≥8 days). The overall incidence of DGF was 62.2%. Higher HLA mismatches was an independent risk factor for prolonged DGF. DGF ≥8 days was associated with acute rejection and this one was associated with patient death in 3 years. DGF with a duration of more than 8 days associated with higher HLA mismatches increases the risk of acute rejection, but graft loss and patient survival are not affected by DGF, regardless of its duration.

Sections du résumé

BACKGROUND BACKGROUND
Delayed graft function (DGF) is an important prognostic indicator after kidney transplantation. Depending on the severity of the ischemia-reperfusion injury, DGF can have several clinical presentations, with different renal function recovery times. Both the presence and duration of DGF can have an impact on kidney transplantation outcomes. However, the definition of the cutoff point, above which the outcomes are worse, varies widely in the literature.
METHODS METHODS
To investigate the impact of DGF and its duration on patient and graft survivals, a single-center retrospective study including all deceased donor kidney transplants was performed between November 2008 and December 2015 (n = 188). Through the analysis on the receiver operating characteristic curve, the cutoff point that determined the worst outcome was reached. DGF patients were then divided according to the duration of DGF (<8 days or ≥8 days).
RESULTS RESULTS
The overall incidence of DGF was 62.2%. Higher HLA mismatches was an independent risk factor for prolonged DGF. DGF ≥8 days was associated with acute rejection and this one was associated with patient death in 3 years.
CONCLUSION CONCLUSIONS
DGF with a duration of more than 8 days associated with higher HLA mismatches increases the risk of acute rejection, but graft loss and patient survival are not affected by DGF, regardless of its duration.

Identifiants

pubmed: 35768295
pii: S0041-1345(22)00296-2
doi: 10.1016/j.transproceed.2022.02.062
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1247-1252

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Auteurs

Flávia Carvalho Leão-Reis (FC)

Transplantation/Nephrology Division, University Hospital of the Faculty of Medical Science, Belo Horizonte, Minas Gerais, Brazil. Electronic address: flavialleao@yahoo.com.br.

Bernardo Duarte Pessoa De Carvalho Silva (BDP)

Transplantation/Nephrology Division, University Hospital of the Faculty of Medical Science, Belo Horizonte, Minas Gerais, Brazil.

Júlia Drumond Parreiras De Morais (JDP)

Transplantation/Nephrology Division, University Hospital of the Faculty of Medical Science, Belo Horizonte, Minas Gerais, Brazil.

Joseph Fabiano Guimarães Santos (JFG)

Epidemiology/Science Health, Governador Israel Pinheiro Hospital/IPSEMG - Belo Horizonte, Minas Gerais, Brazil.

Marcelo Dias-Sanches (M)

Surgery Department - Hospital das Clínicas/ Faculty of Medicine Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, Minas Gerais, Brazil.

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Classifications MeSH