Major effects of delayed graft function and cold ischaemia time on renal allograft survival

Quiroga, Isabel; McShane, Paul; Koo, Dicken D.H.; Gray, Derek W. R.; Friend, Peter J.; Fuggle, Susan V.; Darby, Christopher R.

doi:10.1093/ndt/gfl042

Cited by 290 publications

(247 citation statements)

References 16 publications

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“…Cold ischemia time appears as an important risk factor, consistent with other studies. 2,3 It is a potential target to reduce the risk of DGF. However, most of the other risk factors are predetermined and not amenable to correction.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Delayed Renal Graft Function and Their Impact on Renal Transplantation Outcome

Figueiredo¹,

Moreira²,

Parada³

et al. 2007

Transplantation Proceedings

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Objective. The objective of this study was to evaluate the risk factors for delayed graft function (DGF) and their influence on renal graft outcome. Patients and Methods. We reviewed 1462 consecutive renal transplantation and identified 245 patients (17.1%) with delayed graft function and 1120 patients with immediate graft function. Forty-one cases were excluded because of a nonfunctioning graft as well as 26 other cases because of insufficient data. We compared the incidence, donor and recipient risk factors, and impact on graft outcomes, as well as patient and graft survival of delayed graft function. Results. Donor weight and age, recipient weight, age, length of dialysis, and cold ischemia time were significantly higher in the delayed graft function group. Higher rates of acute rejection and chronic graft dysfunction were observed in this group of patients; we also observed worse graft function and survival. Conclusions. Multiple risk factors are associated with delayed graft function, which contribute decisively to a worse outcome.D ELAYED renal graft function is defined as the need for dialysis within the first week posttransplantation, acute tubular necrosis is its most common cause. However, the consequences far exceed the transient need for dialysis because it may interfere with long-term graft survival. Our purpose was to evaluate the risk factors for delayed renal graft function and to measure their influence on renal graft outcomes. PATIENTS AND METHODSWe retrospectively studied 1462 consecutive renal transplantations performed between 1980 and 2005. All relevant data concerning the donor, the recipient, and the transplantation were inserted into a database. The percentages of patients with immediate diuresis versus delayed graft function (DGF) were calculated. We evaluated risk factors for the occurrence of DGF, either donor-related or recipient-related. Also, the patient and graft survival rates, as well as long-term renal function, were evaluated.Of the 1462 procedures, we excluded 41 cases (2.8%) of never-

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Delayed Renal Graft Function and Their Impact on Renal Transplantation Outcome

Figueiredo¹,

Moreira²,

Parada³

et al. 2007

Transplantation Proceedings

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“…Recent studies have shown that CIT was the most important risk factor for the occurrence of DGF [6,7], Table 1 and while the DGF rate has decreased it still remains high (68.7-38.5%, p < 0.001) [7]. Among our recipients the DGF rate was relatively low (21.6%), since only 1 out of the 12 grafts had the delayed function, which were retrieved in our centre (8.3%), 3 out of the 23 were received from other hospitals of the city of Brest (13%), and 4 out of the 27 were taken from other regions of Brest zone (14.8%).…”

Section: Discussionmentioning

confidence: 99%

Experience of deceased donor kidney transplantation in Brest region

Skachykouskaya¹,

Shestiuk²,

Panko³

et al. 2015

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Introduction: Renal transplantation has progressively increased, and it is the best management of end-stage renal disease. Aim of the research: To evaluate the outcome of renal transplantation from deceased donors to adults living in a region with a population of about one and a half million. Material and methods: A retrospective analysis of the outcomes of 126 recipients of allografts in the period 2011-2014 was performed. The mean age of the recipients was 44.5 ±13.4 years; 71 were male and 55 were female. Kaplan-Meier survival curves were used to assess the graft and recipient survival rates. Results: The overall mortality rate in our study was 4.7% (6 patients), and the mortality of patients with a functioning kidney graft was 3.9% (5 patients). All of them died due to multiple organ failure caused by septic complications of different aetiologies. The data of in our study show that 1-year and 3-year cumulative patient survival after transplantation was 96% and 93.5%, respectively, and the survival rate of kidney grafts was 93% and 68%, respectively. Mean time spent on the renal transplant waiting list had been 31.6 ±7.9 years before the start of the Regional Department of Transplantation, and that was 21.4 ±10.3 (1-141) months in 2014. Conclusions: Three-years of transplant activity in the Brest region resulted in a significant increase in the availability of deceased donor transplantations since every third of the patients with chronic renal failure had kidney allograft transplantation. The 3-year patient survival after transplantation was over 90% owing to up-to-date immunosuppressive regimens and management of postoperative complications.

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“…In a single-center study, multivariate analysis of 518 renal transplant recipients found that DGF was the principal factor underlying kidney survival at one year [51].…”

Section: Delayed Allograft Functionmentioning

confidence: 99%

Live Donor Kidney Transplantation Pearls: A Practical Review

Matter¹,

Abbas²,

Nagib³

et al. 2017

UNOAJ

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Living donation is "a gift of extraordinary value". The use of living donors for renal transplantation was critical for the early development of the field and preceded the use of cadaveric donors. Most donors are related genetically to the recipient, but there are an increasing percentage of cases, where donors are genetically unrelated like spouses, friends, or other emotionally related individuals. Ethical guidelines mandate that the living donors should not be coerced without any evidence of financial profit for the donor. Living donation has been associated with a higher success rate than that seen with cadaveric donation. Conclusion:In view of higher demand for transplantation and the lack of a parallel increase in the number of available cadaveric organs, living donation is important solution for patients to avoid long times on waiting list, and occasionally, even the need of dialysis so, much efforts are needed to encourage living donation rates.

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Major effects of delayed graft function and cold ischaemia time on renal allograft survival

Cited by 290 publications

References 16 publications

Risk Factors for Delayed Renal Graft Function and Their Impact on Renal Transplantation Outcome

Risk Factors for Delayed Renal Graft Function and Their Impact on Renal Transplantation Outcome

Experience of deceased donor kidney transplantation in Brest region

Live Donor Kidney Transplantation Pearls: A Practical Review

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