Effect of Brain-Dead Donor Resuscitation on Delayed Graft Function: Results of a Monocentric Analysis
Autor: | Magali Giral, Georges Karam, Evelyne Bironneau, Yvonnick Blanloeil, Pascal Daguin, Lydie Lerat, Jean-Paul Soulillou, Jean Pierre Bertola, Yohann Foucher, Daniel Villers |
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Rok vydání: | 2007 |
Předmět: |
Adult
Male Brain Death medicine.medical_specialty Resuscitation Time Factors Adolescent Epinephrine Population Delayed Graft Function Hydroxyethyl starch Lower risk Logistic regression Hydroxyethyl Starch Derivatives Sex Factors Risk Factors Intensive care Internal medicine Humans Medicine Risk factor Child education Kidney transplantation Aged Retrospective Studies Aged 80 and over Transplantation education.field_of_study business.industry Cold Ischemia Age Factors Middle Aged medicine.disease Kidney Transplantation Tissue Donors Surgery Logistic Models Child Preschool Hypertension Multivariate Analysis Cardiology Female Kidney Diseases business medicine.drug |
Zdroj: | Transplantation. 83:1174-1181 |
ISSN: | 0041-1337 |
Popis: | We have previously shown that a delayed graft function (DGF) longer than 6 days was a crucial threshold for long-term graft outcome. The aim of this study was to analyze the correlation of DGFor=6 days with brain-dead donor variables, including those related to resuscitation, in a population of 262 consecutive brain-dead donors from 1990 to 2003.We used a marginal logistic model in which DGF was considered as a binary variable with a cutoff of 6 days.Monovariate analysis of donor parameters showed that male, age above 35 years, primary history of hypertension, hydroxyethyl starch (HES) fluid greater than 1500 mL or epinephrine infusion during resuscitation were risk factors for prolonged DGF. The multivariate logistic regression model showed that epinephrine use during donor resuscitation (P0.001, odds ratio [OR]=4.35), cold ischemia time (CIT)or=16 hr (P=0.01, OR=2.16), and recipient age55 years (P=0.003, OR=2.75), were associated with a risk of prolonged DGF. A long stay (40 hr) in intensive care and a large volume of colloids (1250 mL, except HES) correlated with a lower risk of DGF.Our study shows an impact for only a limited number of brain dead donor resuscitation parameters on DGF duration. We also show that CIT has a much lower threshold (16 hr) for DGF risk than previously described. Importantly, we show that recipient age is clearly a major independent risk factor for prolonged DGF, whereas donor age seems to act mostly as a dependent risk factor. |
Databáze: | OpenAIRE |
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