scholarly journals Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hanbi Lee ◽  
Yohan Park ◽  
Tae Hyun Ban ◽  
Sang Heon Song ◽  
Seung Hwan Song ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Allograft Rejection ◽  
Patient Survival ◽  
Graft Function ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Allograft Function ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

AbstractThe aim of this study is to investigate whether or not delayed graft function (DGF) and pre-transplant sensitization have synergistic adverse effects on allograft outcome after deceased donor kidney transplantation (DDKT) using the Korean Organ Transplantation Registry (KOTRY) database, the nationwide prospective cohort. The study included 1359 cases between May 2014 and June 2019. The cases were divided into 4 subgroups according to pre-sensitization and the development of DGF post-transplant [non-pre-sensitized-DGF(−) (n = 1097), non-pre-sensitized-DGF(+) (n = 127), pre-sensitized-DGF(−) (n = 116), and pre-sensitized-DGF(+) (n = 19)]. We compared the incidence of biopsy-proven allograft rejection (BPAR), time-related change in allograft function, allograft or patient survival, and post-transplant complications across 4 subgroups. The incidence of acute antibody-mediated rejection (ABMR) was significantly higher in the pre-sensitized-DGF(+) subgroup than in other 3 subgroups. In addition, multivariable cox regression analysis demonstrated that pre-sensitization combined with DGF is an independent risk factor for the development of acute ABMR (hazard ratio 4.855, 95% confidence interval 1.499–15.727). Moreover, DGF and pre-sensitization showed significant interaction (p-value for interaction = 0.008). Pre-sensitization combined with DGF did not show significant impact on allograft function, and allograft or patient survival. In conclusion, the combination of pre-sensitization and DGF showed significant synergistic interaction on the development of allograft rejection after DDKT.

scholarly journals Combined Impact of Pre-sensitization and Delayed Graft Function on Allograft Rejection in Deceased Donor Kidney Transplantation: Nationwide Cohort Study

2021 ◽  
Author(s):  
Hanbi Lee ◽  
Yohan Park ◽  
Tae Hyun Ban ◽  
Sang Heon Song ◽  
Seung Hwan Song ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Allograft Rejection ◽  
Patient Survival ◽  
Graft Function ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Allograft Function ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Abstract The aim of this study is to investigate whether or not delayed graft function (DGF) and pre-transplant sensitization has a synergistic adverse effect on allograft outcome after deceased donor kidney transplantation (DDKT) using the Korean Organ Transplantation Registry (KOTRY) database, the nationwide prospective cohort. The study included 1,370 cases between May 2014 and June 2019. The cases were divided into 4 subgroups according to pre-sensitization and the development of DGF post-transplant (non-pre-sensitized-DGF(-)(n=1100), non-pre-sensitized-DGF(+)(n=133), pre-sensitized-DGF(-)(n=116), and pre-sensitized-DGF(+)(n=21)). We compared the incidence of biopsy-proven allograft rejection (BPAR), time-related change in allograft function, allograft or patient survival, and post-transplant complications across 4 subgroups. The incidence of overall BPAR and acute antibody-mediated rejection (ABMR) was significantly higher in the pre-sensitized-DGF(+) subgroup than in other 3 subgroups. In addition, multivariable cox regression analysis demonstrated that pre-sensitization combined with DGF is an independent risk factor for both overall BPAR (hazard ratio 3.253, p = 0.005) and acute ABMR (hazard ratio 7.589, p < 0.001). Moreover, DGF and pre-sensitization showed significant interaction. Pre-sensitization combined with DGF did not show significant impact on allograft function, and allograft or patient survival. In conclusion, pre-sensitization and DGF had a synergistic adverse impact on allograft rejection after DDKT.

scholarly journals Predictors and one-year outcomes of patients with delayed graft function after deceased donor kidney transplantation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rao Chen ◽  
Haifeng Wang ◽  
Lei Song ◽  
Jianfei Hou ◽  
Jiawei Peng ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Survival ◽  
Graft Function ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Ischemic Time ◽  
Deceased Donor Kidney ◽  
One Year ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Abstract Background Delayed graft function (DGF) is closely associated with the use of marginal donated kidneys due to deficits during transplantation and in recipients. We aimed to predict the incidence of DGF and evaluate its effect on graft survival. Methods This retrospective study on kidney transplantation was conducted from January 1, 2018, to December 31, 2019, at the Second Xiangya Hospital of Central South University. We classified recipients whose operations were performed in different years into training and validation cohorts and used data from the training cohort to analyze predictors of DGF. A nomogram was then constructed to predict the likelihood of DGF based on these predictors. Results The incidence rate of DGF was 16.92%. Binary logistic regression analysis showed correlations between the incidence of DGF and cold ischemic time (CIT), warm ischemic time (WIT), terminal serum creatine (Scr) concentration, duration of pretransplant dialysis, primary cause of donor death, and usage of LifePort. The internal accuracy of the nomogram was 83.12%. One-year graft survival rates were 93.59 and 99.74%, respectively, for the groups with and without DGF (P < 0.05). Conclusion The nomogram established in this study showed good accuracy in predicting DGF after deceased donor kidney transplantation; additionally, DGF decreased one-year graft survival.

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