Risk factors for delayed kidney function and impact of delayed function on patient and graft survival in adult graft recipients

被引:29
作者
Pieringer, H [1 ]
Biesenbach, G [1 ]
机构
[1] Gen Hosp Linz, Dept Med 2, A-4020 Linz, Austria
关键词
delayed graft function; graft survival; immediate graft function; kidney graft;
D O I
10.1111/j.1399-0012.2005.00360.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
The influence of delayed kidney graft function on allograft outcome is described controversially in the literature. The aim of the study was to evaluate possible risk factors for delayed graft function (DGF) and investigate the impact of DGF on short- and long-term renal allograft function. Two groups were formed: the first one consisted of patients who gained immediate graft function (IGF) (n = 64) after transplantation and the second group included patients with DGF (n = 31; with at least one dialysis needed in first week after transplantation). The DGF group had a statistically significant longer duration on dialyses prior to transplantation (DGF 54 vs. IGF 33 months; p < 0.05), on average more frequently a re-transplantation (DGF 1.7 vs. IGF 1.3; p < 0.01), a longer re-anastomosis time (DGF 52.9 vs. 44.2 min; p < 0.01), a lower systolic (DGF 136 +/- 24 mmHg vs. IGF 158 +/- 25; p < 0.001) and diastolic blood pressure (DGF 78 +/- 14 vs. IGF 89 +/- 16 mmHg; p < 0.01) at admission to the hospital and a higher serum (S)-creatinine at discharge (DGF 2.5 +/- 1.6 vs. IGF 1.6 +/- 0.4 mg/dL; p < 0.01). Prior to transplantation the DGF group had more often advanced vascular diseases (DGF 29.0 vs. IGF 12.5%; p < 0.01) and these patients incurred more frequently new ones during the next 3 yr after transplantation (DGF 22.6 vs. IGF 6.3%; p < 0.001). After 3 yr the graft survival tended to be lower in the DGF group (DGF 74.2 vs. IGF 84.4%; NS), but this difference was not statistically significant.
引用
收藏
页码:391 / 398
页数:8
相关论文
共 33 条
  • [1] Randomized trial of tacrolimus plus mycophenolate mofetil or azathioprine versus cyclosporine oral solution (modified) plus mycophenolate mofetil after cadaveric kidney transplantation: Results at 2 years
    Ahsan, N
    Johnson, C
    Gonwa, T
    Halloran, P
    Stegall, M
    Hardy, M
    Metzger, R
    Shield, C
    Rocher, L
    Scandling, J
    Sorensen, J
    Mulloy, L
    Light, J
    Corwin, C
    Danovitch, G
    Wachs, M
    VanVeldhuisen, P
    Salm, K
    Tolzman, D
    Fitzsimmons, WE
    [J]. TRANSPLANTATION, 2001, 72 (02) : 245 - 250
  • [2] Nephron mass modulates the hemodynamic, cellular, and molecular response of the rat renal allograft
    Azuma, H
    Nadeau, K
    Mackenzie, HS
    Brenner, BM
    Tilney, NL
    [J]. TRANSPLANTATION, 1997, 63 (04) : 519 - 528
  • [3] Cellular and molecular predictors of chronic renal dysfunction after initial ischemia/reperfusion injury of a single kidney
    Azuma, H
    Nadeau, K
    Takada, M
    Mackenzie, HS
    Tilney, NL
    [J]. TRANSPLANTATION, 1997, 64 (02) : 190 - 197
  • [4] Delayed graft function influences renal function, but not survival
    Boom, H
    Mallat, MJK
    De Fijter, JW
    Zwinderman, AH
    Paul, LC
    [J]. KIDNEY INTERNATIONAL, 2000, 58 (02) : 859 - 866
  • [5] Cold ischemia time: An independent predictor of increased HLA class I antibody production after rejection of a primary cadaveric renal allograft
    Bryan, CF
    Luger, AM
    Martinez, J
    Muruve, N
    Nelson, PW
    Pierce, GE
    Ross, G
    Shield, CF
    Warady, BA
    Aeder, MI
    Helling, TS
    [J]. TRANSPLANTATION, 2001, 71 (07) : 875 - 879
  • [6] A comparison of discharge immunosuppressive drug regimens in primary cadaveric kidney transplantation
    Cherikh, WS
    Kauffman, HM
    Maghirang, J
    Bleyer, AJ
    Johnson, CP
    [J]. TRANSPLANTATION, 2003, 76 (03) : 463 - 470
  • [7] Hypertension is an independent predictor of delayed graft function and worse renal function only in kidneys with chronic pathological lesions
    Di Paolo, S
    Stallone, G
    Schena, A
    Infante, B
    Gesualdo, L
    Schena, FP
    [J]. TRANSPLANTATION, 2002, 73 (04) : 623 - 627
  • [8] Feldman HI, 1996, NEPHROL DIAL TRANSPL, V11, P1306
  • [9] Gaber LW, 1996, CLIN TRANSPLANT, V10, P629
  • [10] GOES N, 1995, TRANSPLANTATION, V59, P565