Factors That Predict Duration of Delayed Graft Function in Cadaveric Kidney Transplantation

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

doi:10.1016/j.transproceed.2009.06.076

Cited by 18 publications

(17 citation statements)

References 10 publications

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“…Defined as the necessity for dialysis in the first postoperative week, DGF developed in 33.3% of patients in our study. Others reported DGF in 20-50% of patients receiving a first cadaveric graft (4,5,7). In some studies, DGF was an independent risk factor for allograft survival (7), the same as in our study.…”

Section: Discussionsupporting

confidence: 85%

“…In kidney transplantation, the absence of immediate allograft function is known as delayed graft function (DGF) and is defined as the need for dialysis during the first week after transplantation. The frequency of DGF ranges from 5 to 50% in cadaveric donor kidney transplantations (3)(4)(5). DGF makes the management of patients more difficult, prolongs hospital stay, increases the costs of transplantation, has a negative impact on the rehabilitation of transplant recipients, and reduces graft survival rate (6,7).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ten-year experience of kidney transplantation at the Hospital of Kaunas University of Medicine: demography, complications, graft and patient survival

Dalinkevičienė¹,

Kuzminskis²,

Petrulienė³

et al. 2010

Medicina

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Ten-year experience of kidney transplantation at the Hospital of Kaunas University of Medicine: demography, complications, graft and patient survival

Dalinkevičienė¹,

Kuzminskis²,

Petrulienė³

et al. 2010

Medicina

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“…Cit is a significant risk factor for acute tubular necrosis and delayed graft function in kidney transplant recipients [25] and its duration [26]. In addition, in our study recipients of grafts from living donors were on average 11 years younger, had been 5 years less on chronic hemodialysis and had an average waiting time which was 5 years shorter.…”

Section: Interpretation Of Resultsmentioning

confidence: 59%

Prognostic value of intraoperative renal tissue oxygenation measurement on early renal transplant function

Scheeren¹,

Martin²,

Maruschke³

et al. 2011

Transplant International

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Summary Ischemia time is a prognostic factor in renal transplantation for postoperative graft function and survival. Kidney transplants from living donors have a higher survival rate than deceased donor kidneys probably because of shorter ischemia time. We hypothesized that measurement of intraoperative kidney oxygenation (μHbO2) and microvascular perfusion predicts postoperative graft function. We measured microvascular hemoglobin oxygen saturation by reflectance spectrophotometry and microcirculatory kidney perfusion by laser Doppler flowmetry 5 and 30 min after kidney reperfusion on the organ surface in 53 renal transplant patients including 19 grafts from living donors. These values were related to systemic hemodynamics, cold ischemia time (cit), early postoperative graft function and length of hospital stay. μHbO2 improved 30 min after reperfusion compared to 5 min (from 67% to 71%, P < 0.05). μHbO2 correlated with mean arterial blood pressure and central venous pH (P < 0.01). Most importantly, μHbO2 was significantly higher in kidneys from living compared with deceased donors (74% vs. 63%) and in kidneys without vs. with biopsy‐proven postoperative rejection (71% vs. 45%, P < 0.001). Finally, μHbO2 correlated positively with cit and postoperative creatinine clearance and negatively with postoperative plasma creatinine, need for hemodialysis and length of hospital stay. Our results suggest higher oxygen extraction and thus oxygen demand of the grafts shortly after reperfusion. The intraoperative measurement of tissue oxygenation in kidney transplants is predictive of early postoperative graft function. Future studies should evaluate the potential effect of intraoperative therapeutic maneuvers to improve organ tissue oxygenation in renal transplantation.

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“…67 Risk factors for delayed graft function may include older donors; cold ischemic time ≥ 24 hours; decreased creatinine clearance in the donor; and expanded-criteria donors. 68 A risk-adjusted immunosuppressive program was developed to decrease the incidence of delayed graft function and acute rejection in high-risk patients and improve graft survival. The risk of developing delayed graft function may be decreased with use of rATG given before reperfusion.…”

Section: Delayed Graft Functionmentioning

confidence: 99%

“…The choice of induction therapy may be improve outcomes in high-risk patients in the short-term study. 68 …”

Section: Delayed Graft Functionmentioning

confidence: 99%

Induction Immunosuppressive Therapy in Kidney Transplantation

Bakr

Nagib²,

Donia³

2014

Exp Clin Transplant

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Induction therapy after kidney transplantation is intensive immunosuppression in the initial days after transplant when the immune system of the recipient has the first contact with donor antigens. Initial intensive immunosuppression may be required to prevent acute rejection and graft loss, and subsequent immuno-suppression may be decreased to minimize adverse events associated with immunosuppressive drugs. Induction agents include lymphocyte-depleting antibodies such as rabbit antithymocyte globulin, alemtuzumab, muromonab-CD3, rituximab, and bortezomib; lymphocytenondepleting antibodies such as interleukin 2 receptor antibodies; and other discontinued or investigational agents such as efalizumab and alefacept. Induction therapy may be adjusted for special situations such as living-donor kidney transplant, pediatric transplant, hepatitis C virusseropositive recipients, recipients who require desensitization, patients who are at risk for developing delayed graft function, and old donors. The optimal immunosuppressive regimen may vary, and clinical practice guidelines are available.

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Factors That Predict Duration of Delayed Graft Function in Cadaveric Kidney Transplantation

Cited by 18 publications

References 10 publications

Ten-year experience of kidney transplantation at the Hospital of Kaunas University of Medicine: demography, complications, graft and patient survival

Ten-year experience of kidney transplantation at the Hospital of Kaunas University of Medicine: demography, complications, graft and patient survival

Prognostic value of intraoperative renal tissue oxygenation measurement on early renal transplant function

Induction Immunosuppressive Therapy in Kidney Transplantation

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