Perioperative factors associated with delayed graft function in renal transplant patients

Freitas, Milton Halyson Benevides de; Lima, Luciana Cavalcanti; Couceiro, Tânia Cursino de Menezes; Silva, Wilton Bernadino da; Andrade, J.; Freitas, Marcio Handerson Benevides de

doi:10.1590/2175-8239-jbn-2018-0020

Cited by 6 publications

(11 citation statements)

References 18 publications

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“…More than 5 years of waiting between the initial moment of RRT and KT was a risk factor for the outcome variable, a finding consistent with national and international studies 16,17 . The time in RRT is associated with increased cardiovascular diseases, as well as intensifies the risk of infections and malnutrition 18 .…”

Section: Time Between Start Of Dialysis and Renal Transplantsupporting

confidence: 83%

Modelagem das covariáveis preditivas para falência do enxerto renal até seis meses do transplante

et al. 2022

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Introdução: Transplante renal (TR) é a terapia renal substitutiva (TRS) de escolha para pacientes com doença renal crônica (DRC). Entretanto, nem todo TR é bem-sucedido e alguns pacientes persistem em TRS. Objetivo: Modelar uma regressão logística com covariáveis de risco pré e pós-TR preditora da disfunção secundária do aloenxerto com necessidade de TRS ou alcance ao estágio V da DRC até os primeiros seis meses pós-TR. Métodos: Coorte com receptores transplantados realizado em hospital no Nordeste brasileiro. Analisou-se registros médicos dos TR realizados entre 2011-2018. Receptores com dados insuficientes ou que abandonaram seguimento foram excluídos. Foram analisadas covariáveis: demográficas; infecciosas; comorbidades pré e pós-TR; painel de reatividade; incompatibilidades de HLA; episódios de rejeições agudas mediadas por células-T ou por anticorpos; exames laboratoriais seis meses pós-TR. Resultados: Receptores idosos (OR:1,41; IC95%:1,01-1,99), tempo entre início da TRS e TR (∆T-TRS&TR)>10 anos (OR:3,54; IC95%:1,27-9,87), diabetes mellitus (DM) pré-TR (OR:3,35; IC95%:1,51-7,46), pielonefrite (OR:2,45; IC95%:1,24-4,84), nefropatia por poliomavírus (OR:4,99; IC95%:1,87-13,3), RAMA (OR:4,82; IC95%:1,35-17,2), proteinúria de 24h (Pt24h) ≥300mg/24h (OR:5,05; IC95%:2,00-12,7) e cálcio sérico (Ca)<8,5mg/dL (OR:4,72; IC95%:2,00-11,1) foram identificadas como covariáveis de maior risco para os desfechos analisados até seis meses pós-TR. O modelo multivariado apresentou acurácia de 88,1% e fator de inflação da variância médio de 1,81. Conclusão: Receptores idosos, ∆T-TRS&TR>10anos, DM pré-TR e agressões até seis meses pós-TR (pielonefrite, nefropatia por poliomavírus, RAMA, Pt24h≥300mg/24h e Ca<8,5mg/dL), apresentam alto poder preditivo para disfunção secundária do aloenxerto com necessidade de TRS ou alcance ao estágio V da DRC até os primeiros seis meses pós-TR.

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Section: Time Between Start Of Dialysis and Renal Transplantsupporting

confidence: 83%

Modelagem das covariáveis preditivas para falência do enxerto renal até seis meses do transplante

et al. 2022

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“…Short ischemia times (2-3 h) that are encountered in living donor ktx have been associated with better long-term graft survival as compared to deceased donor ktx. In deceased donor renal transplants, median cold ischemia time (CIT) in Germany can be up to 14 to 16 h. Extended CITs (longer than 25 h) have been reported in other countries (2). Prolonged CIT and old donor age increase the risk of developing delayed graft function (DGF) (3).…”

Section: Introductionmentioning

confidence: 99%

Ischemia Reperfusion Injury Triggers CXCL13 Release and B-Cell Recruitment After Allogenic Kidney Transplantation

et al. 2020

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Ischemia reperfusion injury (IRI) is linked with inflammation in kidney transplantation (ktx). The chemokine CXCL13, also known as B lymphocyte chemoattractant, mediates recruitment of B cells within follicles of lymphoid tissues and has recently been identified as a biomarker for acute kidney allograft rejection. The goal of this study was to explore whether IRI contributes to the up-regulation of CXCL13 levels in ktx. It is demonstrated that systemic levels of CXCL13 were increased in mouse models of uni-and bilateral renal IRI, which correlated with the duration of IRI. Moreover, in unilateral renal IRI CXCL13 expression in ischemic kidneys was up-regulated. Immunohistochemical studies revealed infiltration of CD22+ B-cells and, single-cell RNA sequencing analysis a higher number of cells expressing the CXCL13 receptor CXCR5, in ischemic kidneys 7 days post IRI, respectively. The potential relevance of these findings was also evaluated in a mouse model of ktx. Increased levels of serum CXCL13 correlated with the lengths of cold ischemia times and were further enhanced in allogenic compared to isogenic kidney transplants. Taken together, these findings indicate that IRI is associated with increased systemic levels of CXCL13 in renal IRI and ktx.

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“…Salah satu faktor penting adalah resusitasi intraoperasi yang agresif guna menjaga aliran darah aorta dan status volume sehingga dapat mempertahankan perfusi yang adekuat ke organ donor. 9,12,13 Selain itu, cold ischemic time lebih dari 24 jam berkaitan dengan risiko delayed graft function (DGF) yang lebih tinggi. 12 Studi lain menunjukkan cold ischemic time lebih dari 12 jam pun meningkatkan risiko DGF dengan OR=5,26 (IK 95% 2,62-11,31).…”

Section: Perioperatifunclassified

“…12 Studi lain menunjukkan cold ischemic time lebih dari 12 jam pun meningkatkan risiko DGF dengan OR=5,26 (IK 95% 2,62-11,31). 13…”

Section: Perioperatifunclassified

Luaran Jangka Panjang Transplantasi Ginjal pada Anak

Hidayati¹

2022

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Transplantasi ginjal merupakan pilihan utama terapi pengganti ginjal pada pasien dengan penyakit ginjal kronik stadium 5. Beberapa faktor pada periode pratransplantasi, perioperatif, dan pascatransplantasi ikut memengaruhi luaran jangka panjang pada pasien anak yang menjalani transplantasi ginjal. Faktor-faktor pratransplantasi yang memengaruhi, antara lain, etiologi dasar penyakit ginjal kronik, kondisi fisis sebelum transplantasi, status urodinamik, jenis donor, usia resipien, serta kesesuaian HLA antara resipien dan donor. Teknik pembedahan, kecukupan perfusi darah, dan cold ischemia time selama operasi berperan penting dalam keberhasilan transplantasi. Setelah menjalani prosedur transplantasi, penggunaan obat-obatan imunosupresan jangka panjang secara optimal merupakan kunci keberhasilan transplantasi. Pemantauan secara ketat terhadap kepatuhan terapi, reaksi penolakan organ, infeksi, keganasan, kelainan metabolik, dan gangguan kardiovaskular, dibutuhkan untuk memastikan keberhasilan transplantasi dan mendeteksi adanya komplikasi terkait prosedur transplantasi.

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Perioperative factors associated with delayed graft function in renal transplant patients

Abstract: Combined anesthesia technique, dialysis for more than 60 months, basiliximab, and cold ischemia time > 12 hours are risk factor for DGF, while liberal fluid regimens and kidneys from living donors are protective factors.

Cited by 6 publications

References 18 publications

Modelagem das covariáveis preditivas para falência do enxerto renal até seis meses do transplante

Modelagem das covariáveis preditivas para falência do enxerto renal até seis meses do transplante

Ischemia Reperfusion Injury Triggers CXCL13 Release and B-Cell Recruitment After Allogenic Kidney Transplantation

Luaran Jangka Panjang Transplantasi Ginjal pada Anak

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