Risk Factors and Consequences of Delayed Graft Function in Deceased Donor Renal Transplant Patients Receiving Antithymocyte Globulin Induction

Patel, Samir J.; Duhart, Benjamin; Krauss, Amy; Moore, Linda W.; Egidi, Maria Francesca; Amiri, Hosein-Shokouh; Gaber, Lillian W.; Gaber, A. Osama

doi:10.1097/tp.0b013e31817ef190

Cited by 46 publications

(46 citation statements)

References 41 publications

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“…A systematic review and meta-analysis by Yarlagadda et al 10 combined the results of eight studies that included patient survival as an outcome of interest and found no significant increase in the risk for mortality for patients with DGF. A recent report by Patel et al 11 (published after the period covered by the meta-analysis) revealed that DGF was associated with an increased risk for 12-mo mortality but no difference in death-censored graft failure among high-risk KTR who underwent induction therapy with anti-thymocyte globulin; however, none of the aforementioned studies explicitly evaluated DWGF as an outcome of interest.…”

Section: Discussionmentioning

confidence: 99%

Delayed Graft Function and the Risk for Death with a Functioning Graft

Tapiawala

Tinckam

Cardella

et al. 2010

Journal of the American Society of Nephrology

179

137

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Delayed graft function (DGF) associates with an increased risk for graft failure, but its link with death with graft function (DWGF) is unknown. We used the US Renal Data System to assemble a cohort of all first, adult, deceased-donor kidney transplant recipients from January 1, 1998, through December 31, 2004. In total, 11,542 (23%) of 50,246 recipients required at least one dialysis session in the first week after transplantation. Compared with patients without DGF, patients with DGF were significantly more likely to die with a functioning graft (relative hazard 1.83 [95% confidence interval 1.73 to 1.93] and 1.53 [95% CI 1.45 to 1.63] for unadjusted and fully adjusted models, respectively). The risk for DWGF was slightly higher among women with DGF than among men. There was no significant heterogeneity among other subgroups, and the results were robust to sensitivity analyses. Acute rejection within the first year attenuated the DGF-DWGF association. Cardiovascular and infectious deaths were slightly more prevalent in the DGF group, but the relative hazards of cause-specific death were similar between DWGF and deaths during total follow-up. In summary, DGF associates with an increased risk for DWGF; the mechanisms underlying the negative impact of DGF require further study.

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Section: Discussionmentioning

confidence: 99%

Delayed Graft Function and the Risk for Death with a Functioning Graft

Tapiawala

Tinckam

Cardella

et al. 2010

Journal of the American Society of Nephrology

179

137

View full text Add to dashboard Cite

show abstract

“…Patel et al [59] demonstrated that a high BMI (>30), sirolimus-based regimen, female to male donation and donor creatinine >1.5 mg/dl are independent risk factors for DGF. The patients with DGF had a worse survival compared to non-DGF group at 1 year.…”

Section: Role Of Thymoglobulin In Prevention Of Delayed Graft Functiomentioning

confidence: 99%

Thymoglobulin and Its Use in Renal Transplantation: A Review

2013

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Thymoglobulin (Thymoglobulin®; Genzyme, Cambridge, Mass., USA) is a polyclonal antibody which has been used in the field of transplantation over the last four decades. With an initial hesitancy, it is widely used now in the prevention and treatment of rejection following renal transplantation. Thymoglobulin's lack of nephrotoxic properties (unlike calcineurin inhibitors) may potentiate it to be a very useful induction therapy during the early days following transplantation, particularly in a donation after circulatory death programme. More recently its role in conjunction with inhibitors of terminal complement activation has been shown to be beneficial in cross-match-positive transplantation. This review article consolidates up-to-date available evidence to address the therapeutic role of thymoglobulin in immunological tolerance, ischemia perfusion, live donor transplantation, delayed graft function, prevention and treatment of rejection, graft survival and post-transplant lymphoproliferative disorder following renal transplantation.

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“…Overall, the vast majority of kidney transplants are performed using kidneys from standard criteria donors with moderate DGF rates of 21-31% (7)(8)(9). (10,11).…”

Section: Despite Achieving 1-and 5-year Survival Approaching 90 and 6mentioning

confidence: 99%