Prediction of Kidney Transplant Outcome Based On Different DGF Definitions In Chinese Deceased Donation

Abstract Background Delayed graft function (DGF) is an important complication of kidney transplantation and can be diagnosed according to different definitions. DGF has been suggested to be associated with the long-term outcome of kidney transplantation surgery. However, the best DGF definition for predicting renal transplant outcomes in Chinese donations after cardiac death (DCDs) remains to be determined. Method A total of 372 DCD kidney transplant recipients from June 2013 to July 2017 in the First Affiliated Hospital of Xi’an Jiaotong University were included in this retrospective study to compare 6 different DGF definitions. The relationships of the DGF definitions with transplant outcome were analyzed, including graft loss (GL) and death-censored graft loss (death-censored GL). Renal function indicators, including one-year estimated glomerular filtration rate (eGFR) and three-year eGFR, and were compared between different DGF groups. Results The incidence of DGF varied from 4.19 to 35.22% according to the different DGF diagnoses. All DGF definitions were significantly associated with three-year GL as well as death-censored GL. DGF based on requirement of hemodialysis within the first week had the best predictive value for GL (AUC 0.77), and DGF based on sCr variation during the first 3 days post-transplant had the best predictive value for three-year death-censored GL (AUC 0.79). Combination of the 48-h sCr reduction ratio and classical DGF can improve the AUC for GL (AUC 0.85) as well as the predictive accuracy for death-censored GL (83.3%). Conclusion DGF was an independent risk factor for poor transplant outcome. The combination of need for hemodialysis within the first week and the 48-h serum creatinine reduction rate has a better predictive value for patient and poor graft outcome.

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Prediction of Kidney Transplant Outcome Based On Different DGF Definitions In Chinese Deceased Donation

10.21203/rs.2.10269/v3 ◽

2019 ◽

Author(s):

Xiao-jun Hu ◽

Jin Zheng ◽

Yang Li ◽

Xiao-hui Tian ◽

Pu-xun Tian ◽

...

Keyword(s):

Kidney Transplantation ◽

Kidney Transplant ◽

Predictive Value ◽

Predictive Accuracy ◽

Graft Loss ◽

Graft Function ◽

Reduction Rate ◽

Kidney Transplant Recipients ◽

Long Term Outcome ◽

Transplant Outcome

Abstract Background. Delayed graft function (DGF) is an important complication of kidney transplantation and can be diagnosed according to different definitions. DGF has been suggested to be associated with the long-term outcome of kidney transplantation surgery. However, the best DGF definition for predicting renal transplant outcomes in Chinese donations after cardiac death (DCDs) remains to be determined. Method. A total of 372 DCD kidney transplant recipients from June 2013 to July 2017 in the First Affiliated Hospital of Xi’an Jiaotong University were included in this retrospective study to compare 6 different DGF definitions. The relationships of the DGF definitions with transplant outcome were analyzed, including graft loss (GL) and death-censored graft loss (death-censored GL).Renal function indicators, including one-year estimated glomerular filtration rate (eGFR) and three-year eGFR, and were compared between different DGF groups. Results. The incidence of DGF varied from 4.19% to 35.22% according to the different DGF diagnoses. All DGF definitions were significantly associated with three-year GL as well as death-censored GL. DGF based on requirement of hemodialysis within the first week had the best predictive value for GL (AUC 0.77), and DGF based on sCr variation during the first three days post-transplant had the best predictive value for three-year death-censored GL (AUC 0.79). Combination of the 48-h sCr reduction ratio and classical DGF can improve the AUC for GL (AUC 0.85) as well as the predictive accuracy for death-censored GL (83.3%). Conclusion. DGF was an independent risk factor for poor transplant outcome. The combination of need for hemodialysis within the first week and the 48-h serum creatinine reduction rate has a better predictive value for patient and poor graft outcome.

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Prediction of Kidney Transplant Outcome Based On Different DGF Definitions In Chinese Deceased Donation

10.21203/rs.2.10269/v2 ◽

2019 ◽

Author(s):

Xiao-jun Hu ◽

Jin Zheng ◽

Yang Li ◽

Xiao-hui Tian ◽

Pu-xun Tian ◽

...

Keyword(s):

Kidney Transplantation ◽

Kidney Transplant ◽

Predictive Value ◽

Predictive Accuracy ◽

Graft Loss ◽

Graft Function ◽

Reduction Rate ◽

Kidney Transplant Recipients ◽

Long Term Outcome ◽

Transplant Outcome

Abstract Background. Delayed graft function (DGF) is an important complication of kidney transplantation and can be diagnosed according to different definitions. DGF has been suggested to be associated with the long-term outcome of kidney transplantation surgery. However, the best DGF definition for predicting renal transplant outcomes in Chinese donations after cardiac death (DCDs) remains to be determined. Method. A total of 372 DCD kidney transplant recipients from June 2013 to July 2017 in the First Affiliated Hospital of Xi’an Jiaotong University were included in this retrospective study to compare 6 different DGF definitions. The relationships of the DGF definitions with transplant outcome were analyzed, including graft loss (GL) and death-censored graft loss (death-censored GL).Renal function indicators, including one-year estimated glomerular filtration rate (eGFR) and three-year eGFR, and were compared between different DGF groups. Results. The incidence of DGF varied from 4.19% to 35.22% according to the different DGF diagnoses. All DGF definitions were significantly associated with three-year GL as well as death-censored GL. DGF based on requirement of hemodialysis within the first week had the best predictive value for GL (AUC 0.77), and DGF based on sCr variation during the first three days post-transplant had the best predictive value for three-year death-censored GL (AUC 0.79). Combination of the 48-h sCr reduction ratio and classical DGF can improve the AUC for GL (AUC 0.85) as well as the predictive accuracy for death-censored GL (83.3%). Conclusion. DGF was an independent risk factor for poor transplant outcome. The combination of need for hemodialysis within the first week and the 48-h serum creatinine reduction rate has a better predictive value for patient and poor graft outcome.

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Delayed Graft Function and Long-Term Outcome in Kidney Transplantation

Transplantation Proceedings ◽

10.1016/j.transproceed.2012.06.044 ◽

2012 ◽

Vol 44 (7) ◽

pp. 1879-1883 ◽

Cited By ~ 16

Author(s):

G. Grosso ◽

D. Corona ◽

A. Mistretta ◽

D. Zerbo ◽

N. Sinagra ◽

...

Keyword(s):

Kidney Transplantation ◽

Graft Function ◽

Delayed Graft Function ◽

Term Outcome ◽

Long Term Outcome

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The recovery status from delayed graft function can predict long-term outcome after deceased donor kidney transplantation

Scientific Reports ◽

10.1038/s41598-017-14154-w ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 6

Author(s):

Juhan Lee ◽

Seung Hwan Song ◽

Jee Youn Lee ◽

Deok Gie Kim ◽

Jae Geun Lee ◽

...

Keyword(s):

Kidney Transplantation ◽

Graft Function ◽

Deceased Donor ◽

Donor Kidney ◽

Term Outcome ◽

Long Term Outcome ◽

Deceased Donor Kidney ◽

Donor Kidney Transplantation ◽

Deceased Donor Kidney Transplantation

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

World Journal of Urology ◽

10.1007/s00345-012-0835-z ◽

2012 ◽

Vol 31 (4) ◽

pp. 901-906 ◽

Cited By ~ 16

Author(s):

J. Hellegering ◽

J. Visser ◽

H. J. Kloke ◽

F. C. H. D’Ancona ◽

A. J. Hoitsma ◽

...

Keyword(s):

Kidney Transplantation ◽

Living Donor ◽

Graft Function ◽

Donor Kidney ◽

Term Outcome ◽

Long Term Outcome ◽

Early Graft ◽

Donor Kidney Transplantation ◽

Living Donor Kidney

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Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation

Journal of Clinical Medicine ◽

10.3390/jcm10194395 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4395

Author(s):

Uwe Scheuermann ◽

Sebastian Rademacher ◽

Tristan Wagner ◽

Andri Lederer ◽

Hans-Michael Hau ◽

...

Keyword(s):

Kidney Transplantation ◽

Renal Artery ◽

Graft Survival ◽

Graft Function ◽

Deceased Donor ◽

Renal Arteries ◽

Term Outcome ◽

Long Term Outcome ◽

Arterial Anastomosis

Aim: Complex arterial reconstruction in kidney transplantation (KT) using kidneys from deceased donors (DD) warrants additional study since little is known about the effects on the mid- and long-term outcome and graft survival. Methods: A total of 451 patients receiving deceased donor KT in our department between 1993 and 2017 were included in our study. Patients were divided into three groups according to the number of arteries and anastomosis: (A) 1 renal artery, 1 arterial anastomosis (N = 369); (B) >1 renal artery, 1 arterial anastomosis (N = 47); and (C) >1 renal artery, >1 arterial anastomosis (N = 35). Furthermore, the influence of localization of the arterial anastomosis (common iliac artery (CIA), versus non-CIA) was analyzed. Clinicopathological characteristics, outcome, and graft and patient survival of all groups were compared retrospectively. Results: With growing vascular complexity, the time of warm ischemia increased significantly (groups A, B, and C: 40 ± 19 min, 45 ± 19 min, and 50 ± 17 min, respectively; p = 0.006). Furthermore, the duration of operation was prolonged, although this did not reach significance (groups A, B, and C: 175 ± 98 min, 180 ± 35 min, and 210 ± 43 min, respectively; p = 0.352). There were no significant differences regarding surgical complications, post-transplant kidney function (delayed graft function, initial non-function, episodes of acute rejection), or long-term graft survival. Regarding the localization of the arterial anastomosis, non-CIA was an independent prognostic factor for deep vein thrombosis in multivariate analysis (CIA versus non-CIA: OR 11.551; 95% CI, 1.218–109.554; p = 0.033). Conclusion: Multiple-donor renal arteries should not be considered a contraindication to deceased KT, as morbidity rates and long-term outcomes seem to be comparable with grafts with single arteries and less complex anastomoses.

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