Delayed graft function in pediatric deceased donor kidney transplantation: Donor-related risk factors and impact on two-yr graft function and survival: A single-center analysis

2014 ◽  
Vol 18 (4) ◽  
pp. 357-362 ◽  
Author(s):  
Eleonora Cesca ◽  
Giulia Ghirardo ◽  
Rim Kiblawi ◽  
Luisa Murer ◽  
Piergiorgio Gamba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Graft Function ◽  
Deceased Donor ◽  
Single Center ◽  
Donor Kidney ◽  
Related Risk ◽  
Deceased Donor Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

scholarly journals Risk factors for delayed graft function in deceased donor kidney transplantation; a potential preventive role for intraoperative thymoglobulin

2019 ◽  
Vol 8 (2) ◽  
pp. 157-163
Author(s):  
Neda Naderi ◽  
Azam Alamdari ◽  
Mahboob Lessan-Pezeshki ◽  
Simin Dashti-Khavidaki ◽  
Mehran Heydari-Seradj ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Kidney Transplantation ◽  
Odds Ratio ◽  
Graft Function ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Introduction: Delayed graft function (DGF) is associated with significant adverse outcomes in deceased donor kidney transplantation (KT) including lower graft survival. However, risk factors and potential preventive strategies like intraoperative rabbit antithymocyte globulin (rATG; thymoglobulin) have not yet been fully evaluated. Objectives: The aim of this study was to investigate DGF risk factors and determine the association of intraoperative rATG with the risk of DGF in deceased donor kidney recipients. Patients and Methods: We retrospectively examined medical records of 163 first time deceased donor kidney transplant recipients at two major kidney transplant centers from 2014 to 2016. All the donors were standard heart-beating, brain death donors. Risk factors for DGF in recipients were evaluated using multivariate logistic regression analysis. Results: The mean recipients’ age was 43±13 years and the majority of participants were male (64%). The overall rate of DGF was 27%. Intraoperative rATG was significantly associated with a lower rate of DGF (adjusted odds ratio [AOR], 0.33, 95% CI, 0.11-0.95). Intraoperative transfusion (AOR, 3.7, 95% CI, 1.4-9.9) and diabetes mellitus (AOR, 3.7, 95% CI, 1.5-8.9) were significantly associated with higher risk of DGF. Conclusion: This study showed that intraoperative blood transfusion and diabetes mellitus were associated with increased risk of DGF. Meanwhile, administration of intraoperative rATG was associated with reduced odds ratio of DGF. Future studies are needed to evaluate the potential role of rATG in DGF-related renal outcomes.

Modifiable Risk Factors for Delayed Graft Function After Deceased Donor Kidney Transplantation

2019 ◽  
Vol 29 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Kai B. Kaufmann ◽  
Wolfgang Baar ◽  
Kai Silbach ◽  
Julian Knörlein ◽  
Bernd Jänigen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Graft Function ◽  
Deceased Donor ◽  
Delayed Graft Function ◽  
Patient Specific ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Purpose: Delayed graft function is a major complication after kidney transplantation affecting patients’ long-term outcome. The aim of this study was to identify modifiable risk factors for delayed graft function after deceased donor kidney transplantation. Methods: This is a single-center retrospective cohort study of a university transplantation center. Univariate and multivariate step-wise logistic regression analysis of patient-specific and procedural risk factors were conducted. Results: We analyzed 380 deceased donor kidney transplantation patients between October 30, 2008 and December 30, 2017. The incidence of delayed graft function was 15% (58/380). Among the patient-specific risk factors recipient diabetes (2.8 [1.4-5.9] odds ratio [OR] [95% confidence interval [CI]]), American Society of Anesthesiologist score of 4 (2.7 [1.2-6.5] OR [95% CI]), cold ischemic time >13 hours (2.8 [1.5-5.3] OR [95% CI]) and donor age >55 years (1.9 [1.01-3.6] OR [95% CI]) revealed significance. The significant intraoperative, procedural risk factors included the use of colloids (3.9 [1.4-11.3] OR [95% CI]), albumin (3.0 [1.2-7.5] OR [95% CI]), crystalloids >3000 mL (3.1 [1.2-7.5] OR [95% CI]) and mean arterial pressure <80 mm Hg at the time of reperfusion (2.4 [1.2-4.8] OR [95% CI]). Conclusion: Patients undergoing deceased donor kidney transplantation with a mean arterial pressure >80 mm Hg at the time of transplant reperfusion without requiring excessive fluid therapy in terms of colloids, albumin or crystalloids >3000 mL are less likely to develop delayed graft function.

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