Association Between Delayed Graft Function and Graft Loss in Donation After Cardiac Death Kidney Transplants-A Paired Kidney Registry Analysis
| Autor: | Wai H. Lim, Henry Pleass, Jeremy R. Chapman, Stephen P. McDonald, Bryon Jaques, Germaine Wong, Maggie Km Ma, Graeme R. Russ |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Time Factors medicine.medical_treatment 030232 urology & nephrology Delayed Graft Function Kaplan-Meier Estimate 030230 surgery Risk Assessment Donor Selection 03 medical and health sciences 0302 clinical medicine Risk Factors Cause of Death Medicine Humans Registries Dialysis Cause of death Proportional Hazards Models Transplantation Kidney business.industry Proportional hazards model Donor selection Incidence (epidemiology) Hazard ratio Graft Survival Australia Middle Aged Kidney Transplantation Tissue Donors Surgery medicine.anatomical_structure Treatment Outcome Cardiovascular Diseases Female business Complication New Zealand |
| Zdroj: | Transplantation. 101(6) |
| ISSN: | 1534-6080 |
| Popis: | Delayed graft function (DGF) is an established complication after donation after cardiac death (DCD) kidney transplants, but the impact of DGF on graft outcomes is uncertain. To minimize donor variability and bias, a paired donor kidney analysis was undertaken where 1 kidney developed DGF and the other did not develop DGF using data from the Australia and New Zealand Dialysis and Transplant Registry.Using paired DCD kidney data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the association between DGF, graft and patient outcomes between 1994 and 2012 using adjusted Cox regression models.Of the 74 pairs of DCD kidneys followed for a median of 1.9 years (408 person-years), a greater proportion of recipients with DGF had experienced overall graft loss and death-censored graft loss at 3 years compared with those without DGF (14% vs 4%, P = 0.04 and 11% vs 0%, P0.01, respectively). Compared with recipients without DGF, the adjusted hazard ratio for overall graft loss at 3 years for recipients with DGF was 4.31 (95% confidence interval [95% CI], 1.13-16.44). The adjusted hazard ratio for acute rejection and all-cause mortality at 3 years in recipients who have experienced DGF were 0.98 (95% CI, 0.96-1.01) and 1.70 (95% CI, 0.36-7.93), respectively, compared with recipients without DGF.Recipients of DCD kidneys with DGF experienced a higher incidence of overall and death-censored graft loss compared with those without DGF. Strategies aim to reduce the risk of DGF could potentially improve graft survival in DCD kidney transplants. |
| Databáze: | OpenAIRE |
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