Duration of Delayed Graft Function Is an Important Predictor of 1-Year Serum Creatinine

Domı́nguez, J.; Lira, F.; Rebolledo, R.; Troncoso, P.; Aravena, Carlos; Ortiz, Mauricio; González, Rodrigo

doi:10.1016/j.transproceed.2008.10.028

Cited by 12 publications

(12 citation statements)

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“…Prolonged DGF is a clinically relevant risk factor for long-term kidney graft survival [1,2], as shown also in this study. Donor U-NGAL was significantly higher in transplantations with prolonged DGF compared to those with early function or only short DGF, and donor U-NGAL was also an independent risk factor for prolonged DGF in the multivariate analysis.…”

Section: Discussionsupporting

confidence: 68%

“…However, a considerable number of kidney transplantations from deceased donors are complicated by delayed graft function (DGF). There is no consensus on the ultimate effect of short DGF, lasting less than one week, on graft survival; however, when the duration of allograft dysfunction becomes prolonged, the negative effect on kidney graft survival becomes evident [1,2]. The criteria for deceased donors have been expanded because of organ shortages, and consequently DGF has become more common [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Deceased donor neutrophil gelatinase-associated lipocalin and delayed graft function after kidney transplantation: a prospective study

et al. 2011

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IntroductionExpanding the criteria for deceased organ donors increases the risk of delayed graft function (DGF) and complicates kidney transplant outcome. We studied whether donor neutrophil gelatinase-associated lipocalin (NGAL), a novel biomarker for acute kidney injury, could predict DGF after transplantation.MethodsWe included 99 consecutive, deceased donors and their 176 kidney recipients. For NGAL detection, donor serum and urine samples were collected before the donor operation. The samples were analyzed using a commercial enzyme-linked immunosorbent assay kit (serum) and the ARCHITECT method (urine).ResultsMean donor serum NGAL (S-NGAL) concentration was 218 ng/mL (range 27 to 658, standard deviation (SD) 145.1) and mean donor urine NGAL (U-NGAL) concentration was 18 ng/mL (range 0 to 177, SD 27.1). Donor S-NGAL and U-NGAL concentrations correlated directly with donor plasma creatinine levels and indirectly with estimated glomerular filtration rate (eGFR) calculated using the modification of diet in renal disease equation for glomerular filtration rate. In transplantations with high (greater than the mean) donor U-NGAL concentrations, prolonged DGF lasting longer than 14 days occurred more often than in transplantations with low (less than the mean) U-NGAL concentration (23% vs. 11%, P = 0.028), and 1-year graft survival was worse (90.3% vs. 97.4%, P = 0.048). High U-NGAL concentration was also associated with significantly more histological changes in the donor kidney biopsies than the low U-NGAL concentration. In a multivariate analysis, U-NGAL, expanded criteria donor status and eGFR emerged as independent risk factors for prolonged DGF. U-NGAL concentration failed to predict DGF on the basis of receiver operating characteristic curve analysis.ConclusionsThis first report on S-NGAL and U-NGAL levels in deceased donors shows that donor U-NGAL, but not donor S-NGAL, measurements give added value when evaluating the suitability of a potential deceased kidney donor.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Deceased donor neutrophil gelatinase-associated lipocalin and delayed graft function after kidney transplantation: a prospective study

et al. 2011

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“…Therefore, DGF recovery time is considered a useful index to further categorize DGF, and may be more relevant to the prognosis. Studies have reported that prolonged DGF duration is associated with poorer allograft function [16][17][18][19][20][21], graft survival [17,22,23], and patient survival (infectious mortality) [16,17]. On the other hand, few studies have examined factors that predict the duration of DGF in cadaveric kidney transplantation [24].…”

Section: Introductionmentioning

confidence: 99%

Risk factors and outcomes of prolonged recovery from delayed graft function after deceased kidney transplantation

Zhang

Liu

et al. 2020

Renal Failure

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Objective: We aimed to evaluate the effect of prolonged recovery from DGF on outcomes, using a new definition of DGF recovery time, among deceased donor kidney transplant recipients with DGF, and to examine the risk factors for prolonged recovery. Methods: From 2007 to 2016, 91 deceased donor kidney transplant recipients with DGF were retrospectively analyzed. DGF recovery time was defined as the time from transplantation to achieve a stable estimated glomerular filtration rate (eGFR). Recipients with a DGF recovery time greater than or equal to the median were assigned to the prolonged recovery group, while the others were assigned to the rapid recovery group. Result: The median DGF recovery time was 27 days. Donor terminal eGFR was significantly lower in the prolonged recovery group (n ¼ 46) compared with the rapid recovery group (n ¼ 45) (median 24.9 vs. 65.4 ml/min/1.73m 2 , p ¼ 0.004). The eGFR at 1 year post-transplant in the prolonged recovery group was significantly lower than that in the rapid recovery group (50.6 ± 20.0 vs. 63.5 ± 21.4 ml/min/1.73m 2 , p ¼ 0.005). The risk of adverse outcomes (acute rejection, pneumonia, graft failure, and death) was significantly greater in the prolonged recovery group (hazard ratio 2.604, 95% confidence interval 1.102-6.150, p ¼ 0.029) compared with the rapid recovery group. Conclusion: Decreased donor terminal eGFR is a risk factor for prolonged recovery from DGF after deceased kidney transplantation. Prolonged DGF recovery time is associated with reduced graft function at 1-year post-transplant, and poor transplant outcome.

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“…Delayed graft function (DGF) is a form of AKI and is associated with complicated posttransplant recovery and an inferior 1-year outcome [8-15]. Prolonged DGF has been reported to severely impair the long-term prognosis of kidney transplantation [8,12]. The diagnosis of DGF is currently made on clinical grounds days after transplantation.…”

Section: Introductionmentioning

confidence: 99%

Serum neutrophil gelatinase-associated lipocalin and recovery of kidney graft function after transplantation

et al. 2014

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BackgroundNeutrophil gelatinase-associated lipocalin (NGAL) is a marker for acute kidney injury. We studied whether serum NGAL predicts delayed graft function (DGF) and recovery of kidney function after transplantation.MethodsSerum NGAL was analyzed using commercial ELISA and point-of-care (POC) (Triage®, Biosite) methods. Serum samples were collected from 176 consecutive, deceased-donor kidney recipients just before transplant surgery and on day 1 and 14 after transplantation. The first 132 samples were analyzed with both methods and the remaining samples with the POC method.ResultsThe correlation between the ELISA and POC methods was 0.89, p < 0.0001 and hence the POC method was used for the remaining analyses. DGF was seen in 66/176 patients. Day 1 sNGAL was significantly higher in DGF (588 ng/ml, SD 189.6) compared to early graft function (355 ng/ml, SD 166.2, p < 0.0001) and this difference persisted on day 14. Day 1 sNGAL predicted DGF with an area under the curve (AUC) of 0.853 (CI 0.792-0.914, p < 0.0001). At the optimal cutoff level of 423 ng/ml the sensitivity was 87% and the specificity 77%. In a multivariate analysis, day 1 sNGAL emerged as an independent predictor of DGF. The sNGAL also predicted DGF lasting longer than 14 days with an AUC of 0.825 (CI 0.751-0.899, p < 0.0001). At the optimal cutoff level of 486 ng/ml, the sensitivity was 80% and specificity 75%.ConclusionSerum NGAL predicts clinically significant DGF and is useful in the care of kidney transplant recipients.

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Duration of Delayed Graft Function Is an Important Predictor of 1-Year Serum Creatinine

Cited by 12 publications

References 13 publications

Deceased donor neutrophil gelatinase-associated lipocalin and delayed graft function after kidney transplantation: a prospective study

Deceased donor neutrophil gelatinase-associated lipocalin and delayed graft function after kidney transplantation: a prospective study

Risk factors and outcomes of prolonged recovery from delayed graft function after deceased kidney transplantation

Serum neutrophil gelatinase-associated lipocalin and recovery of kidney graft function after transplantation

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