Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome

被引：99
作者：
Hetzel, GR
Klein, B
Brause, M
Westhoff, A
Willers, R
Sandmann, W
Grabensee, B
机构：
[1] Univ Dusseldorf Klinikum, Klin Nephrol & Rheumatol, D-40225 Dusseldorf, Germany
[2] Univ Dusseldorf, Rechenzentrum, Dept Comp Sci, D-40225 Dusseldorf, Germany
[3] Univ Dusseldorf Klinikum, Dept Vasc Surg & Renal Transplantat, D-40225 Dusseldorf, Germany
来源：
TRANSPLANT INTERNATIONAL | 2002年 / 15卷 / 01期
关键词：
renal transplantation; delayed graft function; donor age; non immunological risk factors; long term allograft survival;
D O I：
10.1007/s00147-001-0368-7
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Delayed graft function (DGF) remains a grieving complication after renal transplantation. In this study, we examined various factors related to organ donation, transport, and transplantation for their influence on the incidence of DGF and on long-term prognosis. The incidence of DGF, renal function after 5 years, and allograft survival were analyzed in 200 kidneys transplanted in Dusseldorf as well as in 193 partner kidneys transplanted at 43 other centers. The main risk factors for DGF were donor age, cold ischemia time (CIT) and organ shipment. DGF itself, as well as donor age, influenced the long term prognosis. A significant relationship between the partner organs regarding clinical outcome was demonstrated. Non-immunological factors strongly influence the clinical results after renal transplantation. Organs of older donors have a limited long-term prognosis. To minimize additional risks, prevention of DGF, especially by reducing CIT, should be regarded as of paramount importance.
引用
收藏
页码：10 / 16
页数：7
相关论文
共 29 条
[1]   Renal transplantation in recipients over the age of 60 - The impact of donor age [J].
Basar, H ;
Soran, A ;
Shapiro, R ;
Vivas, C ;
Scantlebury, VP ;
Jordan, ML ;
Gritsch, HA ;
McCauley, J ;
Randhawa, P ;
Irish, W ;
Hakala, TR ;
Fung, JJ .
TRANSPLANTATION, 1999, 67 (08) :1191-1193
[2]   Delayed graft function influences renal function, but not survival [J].
Boom, H ;
Mallat, MJK ;
De Fijter, JW ;
Zwinderman, AH ;
Paul, LC .
KIDNEY INTERNATIONAL, 2000, 58 (02) :859-866
[3]  
BRENNER BM, 1992, J AM SOC NEPHROL, V3, P162
[4]   Importance of minimizing HLA-DR mismatch and cold preservation time in cadaveric renal transplantation [J].
Connolly, JK ;
Dyer, PA ;
Martin, S ;
Parrott, NR ;
Pearson, RC ;
Johnson, RWG .
TRANSPLANTATION, 1996, 61 (05) :709-714
[5]   ICAM-1 antisense oligodesoxynucleotides prevent reperfusion injury and enhance immediate graft function in renal transplantation [J].
Dragun, D ;
Tullius, SG ;
Park, JK ;
Maasch, C ;
Lukitsch, I ;
Lippoldt, A ;
Gross, V ;
Luft, FC ;
Haller, H .
KIDNEY INTERNATIONAL, 1998, 54 (02) :590-602
[6]   L-arginine-enriched preservation solution decreases ischaemia/reperfusion injury in canine kidneys after long-term cold storage [J].
Erkasap, S ;
Ates, E .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2000, 15 (08) :1224-1227
[7]   CALCIUM-CHANNEL BLOCKERS AND OTHER FACTORS INFLUENCING DELAYED FUNCTION IN RENAL-ALLOGRAFTS [J].
FERGUSON, CJ ;
HILLIS, AN ;
WILLIAMS, JD ;
GRIFFIN, PJA ;
SALAMAN, JR .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1990, 5 (09) :816-820
[8]   Improved graft survival after renal transplantation in the United States, 1988 to 1996. [J].
Hariharan, S ;
Johnson, CP ;
Bresnahan, BA ;
Taranto, SE ;
McIntosh, MJ ;
Stablein, D .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 342 (09) :605-612
[9]  
Hauet T, 2000, J PHARMACOL EXP THER, V292, P254
[10]  
Hollenbeck M, 1999, Nephrol Dial Transplant, V14 Suppl 4, P32, DOI 10.1093/ndt/14.suppl_4.32
123