Graft intolerance syndrome requiring graft nephrectomy after late kidney graft failure: can it be predicted? A retrospective cohort study.

Autor: Bunthof KLW; Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands., Verhoeks CM; Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands., van den Brand JAJG; Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands., Hilbrands LB; Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: Transplant international : official journal of the European Society for Organ Transplantation [Transpl Int] 2018 Feb; Vol. 31 (2), pp. 220-229. Date of Electronic Publication: 2017 Nov 16.
DOI: 10.1111/tri.13088
Abstrakt: Graft nephrectomy is recommended in case of early graft failure. When the graft fails more than 3-6 months after transplantation, it is current practice to follow a wait-and-see policy. A common indication for graft removal is the graft intolerance syndrome. We aimed to create a risk prediction model for the occurrence of graft intolerance resulting in graft nephrectomy. We collected data of kidney transplantations performed in our center between 1980 and 2010 that failed at least 6 months after transplantation. We evaluated the association between baseline characteristics and the occurrence of graft nephrectomy because of graft intolerance using a competing risk regression model. Prognostic factors were included in a multivariate prediction model. In- and exclusion criteria were met in 288 cases. In 48 patients, the graft was removed because of graft intolerance. Donor age, the number of rejections, and shorter graft survival were predictive factors for graft nephrectomy because of the graft intolerance syndrome. These factors were included in a prediction rule. Using donor age, graft survival, and the number of rejections, clinicians can predict the need for graft nephrectomy with a reasonable accuracy.
(© 2017 Steunstichting ESOT.)
Databáze: MEDLINE
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