Delayed Graft Function in the Kidney Transplant

Siedlecki, Andrew; Irish, William; Brennan, Daniel C.

doi:10.1111/j.1600-6143.2011.03754.x

Cited by 628 publications

(584 citation statements)

References 191 publications

Supporting

Mentioning

552

Contrasting

Unclassified

Order By: Relevance

“…We have since instituted criteria for selection of donors as candidates for single or dual transplantation based on biopsy characteristics (9); reduced immunosuppression in elderly recipients of ECD kidneys; and, perhaps most important, focused on avoiding DGF in elderly recipients of these kidneys. This has included shortening cold ischemic time; minimizing warm ischemic time; using machine perfusion in all ECD kidneys; minimizing recipient obesity, diabetes, and high plasma renin activity; placing small kidneys into large recipients; and avoiding the combination of ECD and DCD, all factors known to increase rates of DGF (10). We have also strongly encouraged livingdonor kidneys for elderly recipients.…”

Section: Discussionmentioning

confidence: 99%

Differential Outcomes of Expanded-Criteria Donor Renal Allografts According to Recipient Age

Mezrich

Pirsch

Fernández

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives Expanded-criteria donor (ECD) kidneys are used to expand the number of deceased-donor kidney transplants, often for elderly recipients. This study sought to determine whether older recipients had significantly worse outcomes from receiving ECD kidneys and whether outcomes of ECD versus standard-criteria donor (SCD) kidneys differed in younger recipients.Design, setting, participants, & measurements This is a single-center, retrospective review of all primary deceased-donor kidney transplantations performed between 2000 and 2005. Group 1 consisted of patients $60 years of age (n=189) who received an ECD (n=96) or an SCD (n=93) kidney. Group 2 consisted of patients 40-59 years of age (n=370) who received an ECD (n=105) or an SCD (n=265) kidney.Results Older recipients (group 1) who received ECD kidneys demonstrated significantly shortened 5-year actuarial patient and graft survival rates compared with older recipients of SCD allografts. Group 1 ECD recipients also had significantly worse outcomes than younger (group 2) ECD recipients. In multivariate analysis, ECD kidneys remained an independent predictor of poorer outcome in group 1.Conclusions Morbidity and mortality were increased in elderly recipients of ECD kidneys. These findings may have implications in kidney allocation policy developments that encourage placement of ECD kidneys for older recipients.

show abstract

Section: Discussionmentioning

confidence: 99%

Differential Outcomes of Expanded-Criteria Donor Renal Allografts According to Recipient Age

Mezrich

Pirsch

Fernández

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Se le considera una lesión por isquemia y reperfusión (5) cuyos mecanismos fisiopatológicos involucran el estrés oxidativo, la disfunción mitocondrial y la activación inmunológica (7), lo que no permite la recuperación completa de las células renales, predispone a la atrofia y la muerte celular (8), aumenta el riesgo de rechazo agudo y crónico (3) y la estancia hospitalaria, y reduce la supervivencia del injerto renal (3,6,(9)(10)(11)(12).…”

unclassified

“…El hallazgo de nuevos biomarcadores que detecten en forma no invasiva y temprana la función retardada del injerto, permitiría la implementación de tratamientos para limitar el daño (3,6,14,15) y mejorar el resultado a largo plazo del injerto renal (8,16).…”

unclassified

See 1 more Smart Citation

La lipocalina asociada con la gelatinasa de neutrófilos como factor temprano de predicción de la función retardada del injerto renal

et al. 2016

View full text Add to dashboard Cite

Introducción. La función retardada del injerto renal se presenta en 20 a 50 % de los trasplantes renales. Objetivo. Describir el comportamiento de la lipocalina urinaria asociada a la gelatinasa de neutrófilos en receptores de trasplante renal de donante fallecido y compararlo con el porcentaje de descenso de la creatinina sérica para detectar tempranamente la función retardada del injerto renal. Materiales y métodos. Se evaluaron los niveles de lipocalina urinaria asociada a la gelatinasa de neutrófilos en una cohorte prospectiva 1, 12, 24 y 48 horas después del trasplante renal, y se compararon diariamente con los de la creatinina sérica hasta el quinto día del trasplante. Resultados. Se incluyeron en el estudio 79 pacientes con trasplante renal de donante fallecido. La función retardada del injerto renal se presentó en 13 pacientes (16,5 %) y cinco de ellos (6,3 %) necesitaron diálisis en la primera semana. Los valores de lipocalina urinaria asociada a la gelatinasa de neutrófilos en todos los puntos de corte fueron mayores en los pacientes con función retardada del injerto renal (p=0,526, p=0,049, p=0,032 y p=0,001, respectivamente). Se estableció un valor de más de 120 ng/ml a las 48 horas como factor de predicción de la función retardada del injerto, con una sensibilidad de 75 % y una especificidad de 71 %; el valor de creatinina sérica que mejor discriminó la función retardada se presentó a las 48 horas (59,5 %), con una sensibilidad de 92 % y una especificidad de 83 %. En la regresión logística los únicos valores significativos para predecir la función retardada del injerto renal fueron los de la creatinina serica. Conclusión. Los niveles de lipocalina urinaria asociada a la gelatinasa de neutrófilos a las 48 horas del trasplante renal predijeron la función retardada, incluida la necesidad de diálisis, pero no fueron superiores a los de la creatinina sérica para la detección temprana.

show abstract

“…Delayed graft function (DGF) is one of the most important complications of kidney transplantation which leads to AKI. This results in increased the risk of acute rejection episodes and decreased long-term survival [12,13]. Clinical studies investigating NGAL as a biomarker for DGF include data from 1079 patients after renal transplantation [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

SERUM NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) AS A PREDICTIVE BIOMARKER OF KIDNEY INJURY IN RENAL TRANSPLANTED PATIENTS and CHRONIC KIDNEY DISEASE

Al-Shamma

Alklyali

Alani

2017

Int J Pharm Pharm Sci

View full text Add to dashboard Cite

Objective: Neutrophil gelatinase-associated lipocalin has emerged as a promising biomarker of kidney injury better than creatinine to early predict the acute kidney injury in both chronic kidney diseases and early diagnosis of kidney allograft dysfunction. Methods:Neutrophil gelatinase-associated lipocalin was evaluated as a new biomarker for acute renal injury in 69 patients were divided in two groups chronic kidney disease patients (stage5), (n=34), and renal transplant patients, (n=35) comparing with apparently healthy control (n= 35) of matching age and weight. Neutrophil gelatinase-associated lipocalin, hsCRP and Cystatin-C were measured by enzyme-linked immune sorbent assay which is included first incubating the test serum in an antigen-coated polystyrene plate, then enzyme labelled anti-immunoglobulin is added and the enzyme then remaining in plate after washing provides a measure of the amount of specific antibody in the serum and in the final step a substance is added that the enzyme can convert to some detectable signal, most commonly a color change in a chemical substrate. Results:There was a significant increase in serum NGAL of renal transplantation patients, and CKD patients (stage5) than in healthy control subjects (455±145 ng/ml vs. 296.4±83.5 ng/ml 486±153 ng/ml vs296. 4±83.5 ng/ml) respectively. A high serum Neutrophil gelatinase-associated lipocalin is noted in renal transplanted patients after one month, then after six months (480±188ng/ml vs. 409±78ng/ml). There was a significant negative correlation between serum Neutrophil gelatinase-associated lipocalin in renal transplanted patients, and chronic kidney disease patients (stage 5) with an estimated glomerular filtration rate (p<0.05). Conclusion:Serum neutrophil gelatinase-associated lipocalin seems to be an early predictor of kidney injury and post-transplantation management, including dialysis and grafting function of the kidney.

show abstract

Delayed Graft Function in the Kidney Transplant

Cited by 628 publications

References 191 publications

Differential Outcomes of Expanded-Criteria Donor Renal Allografts According to Recipient Age

Differential Outcomes of Expanded-Criteria Donor Renal Allografts According to Recipient Age

La lipocalina asociada con la gelatinasa de neutrófilos como factor temprano de predicción de la función retardada del injerto renal

SERUM NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) AS A PREDICTIVE BIOMARKER OF KIDNEY INJURY IN RENAL TRANSPLANTED PATIENTS and CHRONIC KIDNEY DISEASE

Contact Info

Product

Resources

About