Decrease in 1-year Kidney Graft Size Predicts Inferior Outcomes After Deceased Donor Kidney Transplantation
| Autor: | Miha Arnol, Jadranka Buturović-Ponikvar, Senka Černe, Aljoša Kandus |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Slovenia 030232 urology & nephrology Urology Kaplan-Meier Estimate 030230 surgery Kidney Kidney transplant 03 medical and health sciences Graft size 0302 clinical medicine Postoperative Complications Predictive Value of Tests Risk Factors medicine Humans Proportional Hazards Models Deceased donor kidney Transplantation Chi-Square Distribution business.industry Graft Survival Ultrasonography Doppler Organ Size Middle Aged Kidney Transplantation surgical procedures operative medicine.anatomical_structure Treatment Outcome ROC Curve Area Under Curve Multivariate Analysis Female business Glomerular Filtration Rate |
| Zdroj: | Transplantation. 100(8) |
| ISSN: | 1534-6080 |
| Popis: | Longest bipolar length of the kidney graft is routinely measured for ultrasonographic assessment of graft size (GS), although the value of the graft length remains unclear.In a single-center, observational study involving 319 deceased-donor kidney transplant recipients, we assessed variations in absolute and adjusted GS (corrected for body surface area) between 1 and 12 months after transplantation ([INCREMENT]GS1m→12m). We tested whether variations in GS during the first year were predictive of the composite outcome of a reduction of 50% or more in the estimated glomerular filtration rate or end-stage graft failure.At 1 year after transplantation, 121 patients (38%) had a decrease in GS ([INCREMENT]GS1m→12m0), and 198 patients (62%) had an increase in GS ([INCREMENT]GS1m→12m ≥0). After a median follow-up of 53 months, 41 patients with a decrease in GS reached the composite outcome as compared with 12 patients with an increase in GS (34% and 6%, respectively; P0.001). Areas under the receiver operating characteristics curves of absolute and adjusted [INCREMENT]GS1m→12m for composite outcome were 0.81 (95% confidence interval [95% CI], 0.74-0.88) and 0.78 (95% CI, 0.70-0.86), respectively. In multivariate analysis, the risk of the composite outcome was significantly higher among patients with a decrease in GS during the first year after transplantation (hazard ratio, 4.55; 95% CI, 2.35-8.81; P0.001).A decrease in kidney GS during the first year after transplantation, as compared with an increase in GS, is a powerful predictor of subsequent graft dysfunction or end-stage graft failure. |
| Databáze: | OpenAIRE |
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