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Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation
PURPOSE: The purpose of this study was to analyze the risk factors for delayed graft function (DGF) and determine its impact on the outcomes of deceased donor (DD) kidney transplantation (KT). METHODS: Between January 2000 and December 2011, we performed 195 DD renal transplants. After the exclusion...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Surgical Society
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595821/ https://www.ncbi.nlm.nih.gov/pubmed/26446498 http://dx.doi.org/10.4174/astr.2015.89.4.208 |
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author | Seo, Chang Ho Ju, Jeong Il Kim, Mi-Hyeong Jun, Kang Woong Ahn, Sang-Hyun Hwang, Jeong Kye Kim, Sang Dong Park, Sun Cheol Choi, Bum Soon Kim, Ji Il Yang, Chul Woo Kim, Yong Soo Moon, In Sung |
author_facet | Seo, Chang Ho Ju, Jeong Il Kim, Mi-Hyeong Jun, Kang Woong Ahn, Sang-Hyun Hwang, Jeong Kye Kim, Sang Dong Park, Sun Cheol Choi, Bum Soon Kim, Ji Il Yang, Chul Woo Kim, Yong Soo Moon, In Sung |
author_sort | Seo, Chang Ho |
collection | PubMed |
description | PURPOSE: The purpose of this study was to analyze the risk factors for delayed graft function (DGF) and determine its impact on the outcomes of deceased donor (DD) kidney transplantation (KT). METHODS: Between January 2000 and December 2011, we performed 195 DD renal transplants. After the exclusion of primary nonfunctional grafts (n = 4), the study recipients were divided into two groups-group I, DGF (n = 31, 16.2%); group II, non-DGF (n = 160, 83.8%). The following variables were compared: donor and recipient characteristics, patient and graft survival, postoperative renal function, acute rejection (AR) episodes, and the rates of surgical and infectious complications. RESULTS: Donor-related variables that showed significant differences included hypertension (P = 0.042), diabetes (P = 0.025), and prerecovery serum creatinine levels (P < 0.001). However, there were no significant differences in recipient-related factors. One significantly different transplant-related factor was positive panel reactive antibody (PRA > 20%, P = 0.008). On multivariate analysis, only the prerecovery serum creatinine level (P < 0.001; hazard ratio [HR], 1.814) was an independent risk factor for the development of DGF. A Cox multivariate analysis of risk factors for graft survival identified these independent risk factors for graft survival: nephron mass (donor kidney weight to recipient body weight ratio) index (P = 0.026; HR, 2.328), CMV infection (P = 0.038; HR, 0.114), and AR episode (P = 0.038; HR, 0.166). CONCLUSION: In DD KT, an independent risk factor for DGF was the prerecovery serum creatinine level. Although there was a significant difference in graft survival between the DGF and non-DGF groups, DGF was not an independent risk factor for graft failure in this study. |
format | Online Article Text |
id | pubmed-4595821 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | The Korean Surgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-45958212015-10-07 Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation Seo, Chang Ho Ju, Jeong Il Kim, Mi-Hyeong Jun, Kang Woong Ahn, Sang-Hyun Hwang, Jeong Kye Kim, Sang Dong Park, Sun Cheol Choi, Bum Soon Kim, Ji Il Yang, Chul Woo Kim, Yong Soo Moon, In Sung Ann Surg Treat Res Original Article PURPOSE: The purpose of this study was to analyze the risk factors for delayed graft function (DGF) and determine its impact on the outcomes of deceased donor (DD) kidney transplantation (KT). METHODS: Between January 2000 and December 2011, we performed 195 DD renal transplants. After the exclusion of primary nonfunctional grafts (n = 4), the study recipients were divided into two groups-group I, DGF (n = 31, 16.2%); group II, non-DGF (n = 160, 83.8%). The following variables were compared: donor and recipient characteristics, patient and graft survival, postoperative renal function, acute rejection (AR) episodes, and the rates of surgical and infectious complications. RESULTS: Donor-related variables that showed significant differences included hypertension (P = 0.042), diabetes (P = 0.025), and prerecovery serum creatinine levels (P < 0.001). However, there were no significant differences in recipient-related factors. One significantly different transplant-related factor was positive panel reactive antibody (PRA > 20%, P = 0.008). On multivariate analysis, only the prerecovery serum creatinine level (P < 0.001; hazard ratio [HR], 1.814) was an independent risk factor for the development of DGF. A Cox multivariate analysis of risk factors for graft survival identified these independent risk factors for graft survival: nephron mass (donor kidney weight to recipient body weight ratio) index (P = 0.026; HR, 2.328), CMV infection (P = 0.038; HR, 0.114), and AR episode (P = 0.038; HR, 0.166). CONCLUSION: In DD KT, an independent risk factor for DGF was the prerecovery serum creatinine level. Although there was a significant difference in graft survival between the DGF and non-DGF groups, DGF was not an independent risk factor for graft failure in this study. The Korean Surgical Society 2015-10 2015-09-25 /pmc/articles/PMC4595821/ /pubmed/26446498 http://dx.doi.org/10.4174/astr.2015.89.4.208 Text en Copyright © 2015, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/4.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Seo, Chang Ho Ju, Jeong Il Kim, Mi-Hyeong Jun, Kang Woong Ahn, Sang-Hyun Hwang, Jeong Kye Kim, Sang Dong Park, Sun Cheol Choi, Bum Soon Kim, Ji Il Yang, Chul Woo Kim, Yong Soo Moon, In Sung Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation |
title | Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation |
title_full | Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation |
title_fullStr | Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation |
title_full_unstemmed | Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation |
title_short | Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation |
title_sort | risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595821/ https://www.ncbi.nlm.nih.gov/pubmed/26446498 http://dx.doi.org/10.4174/astr.2015.89.4.208 |
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