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Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study

Background: Delayed graft function (DGF) is a significant challenge in renal transplantation, particularly with deceased donors, necessitating early postoperative dialysis. The prolonged effects of medium- and long-term DGF remain uncertain, marked by contradictory graft survival outcomes. This inco...

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Autores principales: Salguero, Joseba, Chamorro, Laura, Gómez-Gómez, Enrique, de Benito, Patricia, Robles, Jose E., Campos, Juan P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573826/
https://www.ncbi.nlm.nih.gov/pubmed/37835040
http://dx.doi.org/10.3390/jcm12196397
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author Salguero, Joseba
Chamorro, Laura
Gómez-Gómez, Enrique
de Benito, Patricia
Robles, Jose E.
Campos, Juan P.
author_facet Salguero, Joseba
Chamorro, Laura
Gómez-Gómez, Enrique
de Benito, Patricia
Robles, Jose E.
Campos, Juan P.
author_sort Salguero, Joseba
collection PubMed
description Background: Delayed graft function (DGF) is a significant challenge in renal transplantation, particularly with deceased donors, necessitating early postoperative dialysis. The prolonged effects of medium- and long-term DGF remain uncertain, marked by contradictory graft survival outcomes. This incongruity might arise from the inherent graft resilience and regenerative capacity during transplantation. This study investigates DGF’s impact on graft survival, focusing on grafts displaying favorable (KDRI < 1) and unfavorable outcomes (KDRI ≥ 1). Methods: In this retrospective cohort study (January 2015–December 2019), we assessed kidney transplants at our center, excluding multiorgan simultaneous cases, primary non-functioning grafts, and surgical complications causing graft loss. Patients were categorized into DGF presence or absence groups. Univariate and multivariate analyses, alongside propensity score matching (PSM), were performed. Results: The study encompassed 322 deceased donor kidneys, with 83 encountering DGF. Grafts with higher KDRI indices (KDRI ≥ 1) and DGF exhibited a notably increased graft loss risk (HR: 4.17, 95% CI: 1.93–9.01). However, lower-KDRI donor grafts displayed no significant disparities between the DGF and non-DGF groups. Conclusions: Delayed graft function (DGF) development significantly contributes to graft loss in kidney transplants, particularly in grafts with KDRI ≥ 1.
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spelling pubmed-105738262023-10-14 Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study Salguero, Joseba Chamorro, Laura Gómez-Gómez, Enrique de Benito, Patricia Robles, Jose E. Campos, Juan P. J Clin Med Article Background: Delayed graft function (DGF) is a significant challenge in renal transplantation, particularly with deceased donors, necessitating early postoperative dialysis. The prolonged effects of medium- and long-term DGF remain uncertain, marked by contradictory graft survival outcomes. This incongruity might arise from the inherent graft resilience and regenerative capacity during transplantation. This study investigates DGF’s impact on graft survival, focusing on grafts displaying favorable (KDRI < 1) and unfavorable outcomes (KDRI ≥ 1). Methods: In this retrospective cohort study (January 2015–December 2019), we assessed kidney transplants at our center, excluding multiorgan simultaneous cases, primary non-functioning grafts, and surgical complications causing graft loss. Patients were categorized into DGF presence or absence groups. Univariate and multivariate analyses, alongside propensity score matching (PSM), were performed. Results: The study encompassed 322 deceased donor kidneys, with 83 encountering DGF. Grafts with higher KDRI indices (KDRI ≥ 1) and DGF exhibited a notably increased graft loss risk (HR: 4.17, 95% CI: 1.93–9.01). However, lower-KDRI donor grafts displayed no significant disparities between the DGF and non-DGF groups. Conclusions: Delayed graft function (DGF) development significantly contributes to graft loss in kidney transplants, particularly in grafts with KDRI ≥ 1. MDPI 2023-10-07 /pmc/articles/PMC10573826/ /pubmed/37835040 http://dx.doi.org/10.3390/jcm12196397 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Salguero, Joseba
Chamorro, Laura
Gómez-Gómez, Enrique
de Benito, Patricia
Robles, Jose E.
Campos, Juan P.
Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study
title Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study
title_full Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study
title_fullStr Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study
title_full_unstemmed Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study
title_short Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study
title_sort kidney survival impact of delayed graft function depends on kidney donor risk index: a single-center cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573826/
https://www.ncbi.nlm.nih.gov/pubmed/37835040
http://dx.doi.org/10.3390/jcm12196397
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