Evaluation of severity of delayed graft function in kidney transplant recipients

被引:14
作者
Schrezenmeier, Eva [1 ,4 ]
Mueller, Mia [1 ]
Friedersdorff, Frank [2 ,4 ]
Khadzhynov, Dmytro [1 ]
Halleck, Fabian [1 ]
Staeck, Oliver [1 ]
Durr, Michael [1 ]
Zhang, Kun [3 ,4 ]
Eckardt, Kai-Uwe [1 ]
Budde, Klemens [1 ]
Lehner, Lukas J. [1 ]
机构
[1] Charite Univ Med Berlin, Dept Nephrol & Med Intens Care, Berlin, Germany
[2] Charite Univ Med Berlin, Dept Urol, Berlin, Germany
[3] Charite Univ Med Berlin, Dept Internal Med & Cardiol, Campus Virchow Klinikum, Berlin, Germany
[4] Berlin Inst Hlth, Berlin, Germany
关键词
delayed graft function; hospitalization; KDPI; kidney transplantation; rejection; COLD ISCHEMIA TIME; RISK-FACTORS; RENAL-TRANSPLANTATION; SURVIVAL; REJECTION; ALLOGRAFT; IMPACT; PREDICTION; OUTCOMES; ERA;
D O I
10.1093/ndt/gfab304
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background The most common definition of delayed graft function (DGF) relies on dialysis during the first week post-transplant and does not consider DGF severity. The impact of DGF severity on long-term graft outcome remains controversial. Methods We analysed 627 deceased-donor kidney transplant recipients (KTRs) transplanted in 2005-2015 at our centre for DGF severity, associated risk factors and long-term consequences of DGF. Results We found 349 (55.7%) KTRs with DGF, which were classified into four groups according to DGF duration (0-1, 2-7, 8-14, >14 days) and were compared with KTR with no DGF. A longer duration of DGF was associated with progressive worsening of 10-year death-censored graft survival {no DGF: 88.3% [95% confidence interval (CI) 82.4-94.2]; 0-1 day: 81.3% [95% CI 68.2-94.4], 2-7 days: 61.5% [95% CI 43.1.1-79.9], 8-14 days: 66.6% [95% CI 47.4-85.8], >14 days: 51.2% [95% CI 33-69.4]; P < 0.001}. In kidneys with a Kidney Donor Profile Index (KDPI) >= 85%, all DGF severity groups demonstrated reduced graft survival. However, in the <85% KDPI kidneys, only >14 days DGF duration showed worse outcomes. Conclusions DGF had a duration-dependent effect on graft survival, which varied depending on the KDPI. Of note, 0- to 1-day DGF showed comparable results to no DGF in the whole cohort.
引用
收藏
页码:973 / 981
页数:9
相关论文
共 37 条
  • [1] Similar Outcomes with Different Rates of Delayed Graft Function May Reflect Center Practice, Not Center Performance
    Akkina, S. K.
    Connaire, J. J.
    Israni, A. K.
    Snyder, J. J.
    Matas, A. J.
    Kasiske, B. L.
    [J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2009, 9 (06) : 1460 - 1466
  • [2] Relevance of KDPI value and acute rejection on kidney transplant outcomes in recipients with delayed graft function - a retrospective study
    Arias-Cabrales, Carlos E.
    Perez-Saez, Maria Jose
    Redondo-Pachon, Dolores
    Buxeda, Anna
    Burballa, Carla
    Duran, Xavier
    Mir, Marisa
    Crespo, Marta
    Pascual, Julio
    [J]. TRANSPLANT INTERNATIONAL, 2020, 33 (09) : 1071 - 1077
  • [3] Delayed Graft Function in Renal Transplant Recipients: Risk Factors and Impact on 1-Year Graft Function: A Single Center Analysis
    Bronzatto, E. J. M.
    Quadros, K. R. da Silva
    Santos, R. L. S.
    Alves-Filho, G.
    Mazzali, M.
    [J]. TRANSPLANTATION PROCEEDINGS, 2009, 41 (03) : 849 - 851
  • [4] Buchanan PM., 2012, J NEPHROL THER, V2012, P001
  • [5] Summary of FDA Workshop on Ischemia Reperfusion Injury in Kidney Transplantation
    Cavaille-Coll, M.
    Bala, S.
    Velidedeoglu, E.
    Hernandez, A.
    Archdeacon, P.
    Gonzalez, G.
    Neuland, C.
    Meyer, J.
    Albrecht, R.
    [J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2013, 13 (05) : 1134 - 1148
  • [6] Recipient Risk Factors Associated With Delayed Graft Function: A Paired Kidney Analysis
    Doshi, Mona D.
    Garg, Neha
    Reese, Peter P.
    Parikh, Chirag R.
    [J]. TRANSPLANTATION, 2011, 91 (06) : 666 - 671
  • [7] Eurotransplant, 2014, ANN REP 2014
  • [8] The risk of allograft failure and the survival benefit of kidney transplantation are complicated by delayed graft function
    Gill, Jagbir
    Dong, Jianghu
    Rose, Caren
    Gill, John S.
    [J]. KIDNEY INTERNATIONAL, 2016, 89 (06) : 1331 - 1336
  • [9] Delayed graft function of more than six days strongly decreases long-term survival of transplanted kidneys
    Giral-Classe, M
    Hourmant, M
    Cantarovich, D
    Dantal, J
    Blancho, G
    Daguin, P
    Ancelet, D
    Soulillou, JP
    [J]. KIDNEY INTERNATIONAL, 1998, 54 (03) : 972 - 978
  • [10] Banff 2013 Meeting Report: Inclusion of C4d-Negative Antibody-Mediated Rejection and Antibody-Associated Arterial Lesions
    Haas, M.
    Sis, B.
    Racusen, L. C.
    Solez, K.
    Glotz, D.
    Colvin, R. B.
    Castro, M. C. R.
    David, D. S. R.
    David-Neto, E.
    Bagnasco, S. M.
    Cendales, L. C.
    Cornell, L. D.
    Demetris, A. J.
    Drachenberg, C. B.
    Farver, C. F.
    Farris, A. B., III
    Gibson, I. W.
    Kraus, E.
    Liapis, H.
    Loupy, A.
    Nickeleit, V.
    Randhawa, P.
    Rodriguez, E. R.
    Rush, D.
    Smith, R. N.
    Tan, C. D.
    Wallace, W. D.
    Mengel, M.
    [J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2014, 14 (02) : 272 - 283