Outcomes for primary kidney transplantation from donation after Citizens’ death in China: a single center experience of 367 cases

Xue, Wei; Tian, Puxun; Xiang, Hao; Ding, Xiaoming; Pan, Xiaoming; H, Yan; Hou, Jianquan; Xiong, Feng; LinJuan, Liu; Ding, Chenguang; Tian, Xin; Li, Yang; Zheng, Jin

doi:10.1186/s12913-017-2190-7

Cited by 16 publications

(7 citation statements)

References 24 publications

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“…In this study, the overall incidence of DGF was 17.6%, and the DGF rates for DBD and DCD cases were 10% and 28%, respectively. The incidences of DGF in the current study are in line with several recent reports of Chinese population from the other large transplant centers [ 21 – 23 ] and the donor and recipient characteristics are similar between these large transplant centers. These evidences indicated the study population in our center was representative of the national population.…”

Section: Discussionsupporting

confidence: 91%

Evaluation of predictive models for delayed graft function of deceased kidney transplantation

et al. 2017

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BackgroundThis study aimed to evaluate the predictive power of five available delayed graft function (DGF)-prediction models for kidney transplants in the Chinese population.ResultsAmong the five models, the Irish 2010 model scored the best in performance for the Chinese population. Irish 2010 model had an area under the receiver operating characteristic (ROC) curve of 0.737. Hosmer-Lemeshow goodness-of-fit test showed that the Irish 2010 model had a strong correlation between the calculated DGF risk and the observed DGF incidence (p = 0.887). When Irish 2010 model was used in the clinic, the optimal upper cut-off was set to 0.5 with the best positive likelihood ratio, while the lower cut-off was set to 0.1 with the best negative likelihood ratio. In the subgroup of donor aged ≤ 5, the observed DGF incidence was significantly higher than the calculated DGF risk by Irish 2010 model (27% vs. 9%).Materials and MethodsA total of 711 renal transplant cases using deceased donors from China Donation after Citizen's Death Program at our center between February 2007 and August 2016 were included in the analysis using the five predictive models (Irish 2010, Irish 2003, Chaphal 2014, Zaza 2015, Jeldres 2009).ConclusionsIrish 2010 model has the best predictive power for DGF risk in Chinese population among the five models. However, it may not be suitable for allograft recipients whose donor aged ≤ 5-year-old.

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Section: Discussionsupporting

confidence: 91%

Evaluation of predictive models for delayed graft function of deceased kidney transplantation

et al. 2017

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“…A pilot program of organ donation from deceased citizens initiated by the Chinese government has become the only source of deceased donors for renal transplantation since 2015 [ 5 ]. With the recent rapid increase in renal transpiration from deceased donors, the DGF rate after renal transplantation, especially from the high-risk donors, significantly increased [ 6 , 7 ] up to 25% in China, similar to that in the US [ 8 , 9 ]. The high rate of DGF significantly reduces the early recovery of the recipients and burdens both the hospitals and patients.…”

Section: Introductionmentioning

confidence: 99%

A prediction model of delayed graft function in deceased donor for renal transplant: a multi-center study from China

et al. 2021

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Background Kidneys obtained from deceased donors increase the incidence of delayed graft function (DGF) after renal transplantation. Here we investigated the influence of the risk factors of donors with DGF, and developed a donor risk scoring system for DGF prediction. Methods This retrospective study was conducted in 1807 deceased kidney donors and 3599 recipients who received donor kidneys via transplants in 29 centers in China. We quantified DGF associations with donor clinical characteristics. A donor risk scoring system was developed and validated using an independent sample set. Results The incidence of DGF from donors was 19.0%. Six of the donor characteristics analyzed, i.e., age, cause of death, history of hypertension, terminal serum creatinine, persistence of hypotension, and cardiopulmonary resuscitation (CPR) time were risk factors for DGF. A 49-point scoring system of donor risk was established for DGF prediction and exhibited a superior degree of discrimination. External validation of DGF prediction revealed area under the receiver-operating characteristic (AUC) curves of 0.7552. Conclusions Our study determined the deceased donor risk factors related to DGF after renal transplantation pertinent to the Chinese cohort. The scoring system developed here had superior diagnostic significance and consistency and can be used by clinicians to make evidence-based decisions on the quality of kidneys from deceased donors and guide renal transplantation therapy.

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“…[11,30] What's more, controlled DCD was performed under the circumstance that brain death was not approved by legislation in China, which had positive effects on outcome of grafts and recipients. [31]…”

Section: Discussionmentioning

confidence: 99%

Comparison of nighttime and daytime operation on outcomes of kidney transplant with deceased donors

Guo

Liu

et al. 2019

Chinese Medical Journal

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Background: Kidney transplant is always emergent operations and frequently need to be performed at nighttime to reduce cold ischemia time (CIT). Previous studies have revealed that fatigue and sleep deprivation can result in adverse consequences of medical procedures. This study aimed to evaluate whether nighttime operation has adverse impact on kidney transplant. Methods: A retrospective analysis of recipients accepted kidney transplant from deceased donors in one center from 2014 to 2016 was performed. Daytime transplant was defined as operation started after 8 am or ended before 8 pm and nighttime operation was defined as operation ended after 8 pm or started before 8 am . The incidences of complications such as delayed graft function, acute rejection, surgical complications and nosocomial infections were compared between 2 groups. Student's t -test was used to analyze continuous variables such as serum creatinine (Scr) at 1-year of post-transplant. The Chi-square test was used to analyze categorical variables. Differences in recipients and graft survival were analyzed using Kaplan–Meier methodology and log-rank tests. Results: Among the 443 recipients, 233 (52.6%) were classified into the daytime group and the others 210 (47.4%) were in the nighttime group. The 1-year survival rate of recipients was similar for the recipients in the daytime and nighttime groups (95.3% vs. 95.2%, P = 0.981). Although the 1-year graft survival rate in the nighttime group was slightly superior to that in the daytime group, the difference was not significant (92.4% vs. 88.4%, P = 0.164). Furthermore, Scr and incidence of complications were also not significantly different between the 2 groups. Conclusions: Our results suggested that operation time of kidney transplant with short CIT has no significant impact on the outcome of kidney transplant. Nighttime operation of kidney transplant with short CIT could be postponed to the following day to alleviate the burden on medical staffs and avoid the potential risk.

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Outcomes for primary kidney transplantation from donation after Citizens’ death in China: a single center experience of 367 cases

Cited by 16 publications

References 24 publications

Evaluation of predictive models for delayed graft function of deceased kidney transplantation

Evaluation of predictive models for delayed graft function of deceased kidney transplantation

A prediction model of delayed graft function in deceased donor for renal transplant: a multi-center study from China

Comparison of nighttime and daytime operation on outcomes of kidney transplant with deceased donors

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