Implications of donor disseminated intravascular coagulation on kidney allograft recipients.
| Autor: | Wang CJ; Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, Kansas 66160, USA. cwang@kumc.edu, Shafique S, McCullagh J, Diederich DA, Winklhofer FT, Wetmore JB |
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| Jazyk: | angličtina |
| Zdroj: | Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2011 May; Vol. 6 (5), pp. 1160-7. Date of Electronic Publication: 2011 Mar 03. |
| DOI: | 10.2215/CJN.07280810 |
| Abstrakt: | Background and Objectives: Disseminated intravascular coagulation (DIC) is common in deceased kidney donors and is considered a relative contraindication to donation. The significance of donor DIC on recipient kidney function is poorly understood. Additionally, the significance of thrombocytopenia in recipients of kidneys from DIC-positive donors is understudied. Design, Setting, Participants, & Measurements: In a retrospective cohort of 162 kidney transplants, the presence of DIC in donors, the occurrence of thrombocytopenia in recipients, and risk factors for delayed or slow graft function (DGF/SGF) were assessed. The effects of DIC donor status on DGF/SGF in the study sample as a whole, and of thrombocytopenia on DGF/SGF in recipients of DIC-positive kidneys specifically, were examined using multiple logistic regression. Results: DIC donor status was not associated with occurrence of DGF/SGF, but thrombocytopenia was significantly associated with DIC-positive donor status (P=0.008). Thrombocytopenia was independently associated with DGF/SGF only in the recipients of DIC-positive kidneys (P=0.005). Patient and graft survival at 1 year were not affected by donor DIC status or by thrombocytopenia status. Conclusions: Donor DIC was not associated with short-term suboptimal graft function, defined as DGF/SGF, nor with long-term patient or graft survival. However, thrombocytopenia appears to portend DGF/SGF in recipients of DIC-positive kidneys and may be a clinical sign on which the basis of therapeutic decisions could be undertaken. (Copyright © 2011 by the American Society of Nephrology) |
| Databáze: | MEDLINE |
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