A pair analysis of the delayed graft function in kidney recipient: The critical role of the donor
| Autor: | Valérie Gissot, Michel Pinsard, Pol-Louis Longeard, René Robert, Thierry Hauet, Joelle Guilhot, Jean-Paul Jacob, François Seguin |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Brain Death medicine.medical_specialty Adolescent Urology Delayed Graft Function Hemodynamics Critical Care and Intensive Care Medicine Citric Acid Methylamines Young Adult Risk Factors medicine Humans Lactic Acid Prospective Studies Young adult Child Prospective cohort study Kidney transplantation Aged Univariate analysis Kidney business.industry Age Factors Odds ratio Middle Aged medicine.disease Kidney Transplantation Tissue Donors Surgery Transplantation Logistic Models medicine.anatomical_structure Female business Biomarkers |
| Zdroj: | Journal of Critical Care. 25:582-590 |
| ISSN: | 0883-9441 |
| DOI: | 10.1016/j.jcrc.2010.02.011 |
| Popis: | Purpose: The aim of this study was to analyze the importance of donor factors and especially the potential role of hemodynamic management in regard to delayed graft function in paired kidney recipient patients after renal transplantation and to analyze the urine of organ donors by proton-nuclear magnetic resonance spectroscopy to identify urine markers potentially correlated with delayed graft function in recipient patients. Methods: A prospective multicenter epidemiologic study was conducted. A logistic regression model taking into account paired data was used. Results: Data from 72 donors and the 144 corresponding paired recipients were analyzed. Univariate analysis showed that age of donor, previous history of tobacco, ischemic cause of brain death, norepinephrine infusion, and recipient age were the risk factors for delayed graft function. After adjusting for correlated outcome data and controlling for other potential prognostic factors, 3 variables remained significantly associated with outcome: donor age (odds ratio [OR], 10.7), hemodynamic status (OR, 0.167), and hydroxyl-ethyl starch infusion (OR, 0.135). Proton-nuclear magnetic resonance analysis evidenced 3 metabolites of interest in donors (trimethylamine-N-oxide, citrate, and lactate). However, these peaks were not correlated the clinical parameters in donors. Conclusions: Paired analysis of kidney transplantation emphasizes the important role of factor donor associated with delayed graft function in recipient. Thus, a particular attention should be paid to the hemodynamic management of donor. |
| Databáze: | OpenAIRE |
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