Effect of Delayed Graft Function on the Outcome and Allograft Survival of Kidney Transplanted Patients from a Deceased Donor

Maia, Lorena Fernandes; Lasmar, Marcus Faria; Fabreti‐Oliveira, R. A.; Nascimento, Evaldo

doi:10.1016/j.transproceed.2021.04.002

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…Our sub-analysis of serum creatinine at 1 month and 1 year was found to be significantly different in the DGF and non-DGF groups. We did not compound the rejection data or biopsy findings in analyzing the graft function as it was not the primary GFR at 1 month (median, IQR) ml/min 37 (25-45.5) GFR 1 year (median, IQR) ml/min 40 (30.5-51.5) aim of our study, but similar findings have been reported in other studies (4,5,8,16,28).…”

Section: The Adverse Impact Of Dgf Has Been Well Establishedsupporting

confidence: 83%

Renal transplant anastomotic time–Every minute counts!

2023

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The impact of anastomotic time in renal transplant is under recognized and not well studied. It is one of the few controllable factors that affect the incidence of delayed graft function (DGF). Our study aimed at quantifying the impact of anastomotic time. We performed a retrospective review of 424 renal transplants between the years 2006 and 2020. A total of 247 deceased donor renal transplants formed the study cohort. Patients were divided into two groups based on the presence or absence of DGF. Variables with p < 0.3 were analyzed using the binary logistic regression test. The final analysis showed anastomotic time to be significantly associated with DGF with odds ratio of 1.04 per minute corresponding to 4% increase in DGF incidence with every minute increment in anastomotic time. Other variables that had significant impact on DGF were DCD donor (odds ratio – 8.7) and donor terminal creatinine. We concluded that anastomotic time had significant impact on the development of DGF and hence should be minimized.

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Section: The Adverse Impact Of Dgf Has Been Well Establishedsupporting

confidence: 83%

Renal transplant anastomotic time–Every minute counts!

2023

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“…In contrast, CEUS-KDPI, established for the first time in the present study, is a noninvasive, potential predictor of DGF that can be performed pre-procurement for brain-dead donor kidney transplantation. DGF is a common early complication after deceased donor kidney transplantation, with an incidence between 5% and 50%, and it is associated with an increased risk of early postoperative acute rejection, prolonged hospital stay, and decreased long-term graft survival [17,21]. DGF is mainly due to acute post-ischemic tubular necrosis caused by ischemia-reperfusion injury before and during transplantation, with the involvement of inflammatory responses and immune factors [17,22,23].…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasonography-based renal blood perfusion in brain-dead donors predicts early graft function

He¹,

Xu²,

Gong³

et al. 2023

Ultrasonography

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Purpose: The aim of this study was to quantify renal microcirculatory perfusion in braindead donors using contrast-enhanced ultrasonography (CEUS), and to establish an accurate, noninvasive, and convenient index for predicting delayed graft function (DGF) post-transplantation.Methods: In total, 90 brain-dead donor kidneys (training group, n=60; validation group, n=30) examined between August 2020 and November 2022 were recruited in this prospective study. CEUS was performed on the kidneys of brain-dead donors 24 hours before organ procurement and time-intensity curves were constructed. The main measures were arrival time, time to peak, and peak intensity of the kidney segmental arteries, cortex, and medulla. Recipients were divided into DGF and non-DGF groups according to early post-transplant graft function. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic performance.Results: The arrival time of the kidney segmental artery and cortex and the time interval between the time to peak of the segmental artery and cortex were identified as independent factors associated with DGF by multivariate stepwise regression analysis. A new index for the joint prediction model of three variables, the contrast-enhanced ultrasonography/Kidney Donor Profile index (CEUS-KDPI), was developed. CEUS-KDPI showed high accuracy for predicting DGF (training group: AUC, 0.91; sensitivity, 90.5%; specificity, 92.3%; validation group: AUC, 0.84; sensitivity, 75.0%; specificity, 92.3%).Conclusion: CEUS-KDPI accurately predicted DGF after kidney transplantation. CEUS may be a potential noninvasive tool for bedside examinations before organ procurement and may be used to predict early renal function after kidney transplants kidneys from donors after brain death.

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