Poor early graft function impairs long-term outcome in living donor kidney transplantation

Autor: J.A. van der Vliet, Michiel C. Warlé, Frank C H d'Ancona, Andries J. Hoitsma, H. J. Kloke, Jetze Visser, J. Hellegering
Rok vydání: 2013
Předmět:
Nephrology
Male
Time Factors
Kidney
Graft function
chemistry.chemical_compound
Risk Factors
Living Donors
Medicine
Longitudinal Studies
Warm Ischemia
Kidney transplantation
Renal disorder [IGMD 9]
Graft Survival
Cardiovascular diseases Tissue engineering and pathology [NCEBP 14]
Middle Aged
Survival Rate
medicine.anatomical_structure
surgical procedures
operative
Treatment Outcome
Creatinine
Acute rejection
Original Article
Female
Kidney Diseases
Adult
medicine.medical_specialty
Delayed graft function (DGF)
Living donor kidney transplantation (LDKT)
Poor early graft function (pEGF)
Urology
Living donor
Auto-immunity
transplantation and immunotherapy [N4i 4]
Quality of Care [ONCOL 4]
Renal Dialysis
Internal medicine
Humans
Obesity
Survival rate
Retrospective Studies
business.industry
Retrospective cohort study
medicine.disease
Kidney Transplantation
Surgery
Slow graft function (SGF)
chemistry
Evaluation of complex medical interventions [NCEBP 2]
business
Zdroj: World Journal of Urology, 31, 901-6
World Journal of Urology, 31, 4, pp. 901-6
World Journal of Urology
ISSN: 0724-4983
Popis: Contains fulltext : 117447.pdf (Publisher’s version ) (Open Access) BACKGROUND: Poor early graft function (EGF) after living donor kidney transplantation (LDKT) has been found to decrease rejection-free graft survival rates. However, its influence on long-term graft survival remains inconclusive. METHODS: Data were collected on 472 adult LDKTs performed between July 1996 and February 2010. Poor EGF was defined as the occurrence of delayed or slow graft function. Slow function was defined as serum creatinine above 3.0 mg/dL at postoperative day 5 without dialysis. RESULTS: The incidence of slow and delayed graft function was 9.3 and 4.4%, respectively. Recipient overweight, pretransplant dialysis and warm ischemia were identified as risk factors for the occurrence of poor EGF. The rejection-free survival was worse for poor EGF as compared to immediate graft function with an adjusted hazard ratio (HR) of 6.189 (95% CI 4.075-9.399; p < 0.001). Long-term graft survival was impaired in the poor EGF group with an adjusted HR of 4.206 (95% CI 1.839-9.621; p = 0.001). CONCLUSIONS: Poor EGF occurs in 13.7% of living donor kidney allograft recipients. Both, rejection-free and long-term graft survivals are significantly lower in patients with poor EGF as compared to patients with immediate graft function. These results underline the clinical relevance of poor EGF as phenomenon after LDKT.
Databáze: OpenAIRE
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