The prognostic value of time needed on dialysis in patients with delayed graft function

Marek, Caitlyn; Thomson, Benjamin; Shoker, Ahmed; Luke, Patrick; Möser, Michael

doi:10.1093/ndt/gft412

Cited by 17 publications

(18 citation statements)

References 17 publications

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“…Marek et al [31] found an independent association between duration of dialysis dependency post-transplant and 1-year eGFR, but did not examine graft survival. Thirty-five of 83 recipients with DGF post-transplant had received kidneys from DCD donors, and a separate analysis was not performed.…”

Section: Discussionmentioning

confidence: 98%

“…Transplant International 2019; 32: 635-645 transplantation, but have not examined DCD donor kidneys specifically [29][30][31]. To our knowledge, the only study that has done so prior to ours was that of Renkens et al [18], who analysed transplants from 39 uncontrolled and 66 controlled DCD donors.…”

Section: Discussionmentioning

confidence: 99%

“…Large studies have examined post‐transplant dialysis duration and graft outcomes in deceased donor kidney transplantation, but have not examined DCD donor kidneys specifically . To our knowledge, the only study that has done so prior to ours was that of Renkens et al .…”

Section: Discussionmentioning

confidence: 99%

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Duration of delayed graft function and outcomes after kidney transplantation from controlled donation after circulatory death donors: a retrospective study

et al. 2019

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Summary The impact of the duration of delayed graft function (DGF) on graft survival is poorly characterized in controlled donation after circulatory death (DCD) donor kidney transplantation. A retrospective analysis was performed on 225 DCD donor kidney transplants between 2011 and 2016. When patients with primary nonfunction were excluded (n = 9), 141 recipients (65%) had DGF, with median (IQR) duration of dialysis dependency of 6 (2–11.75) days. Longer duration of dialysis dependency was associated with lower estimated glomerular filtration rate at 1 year, and a higher rate of acute rejection. On Kaplan–Meier analysis, the presence of DGF was associated with lower graft survival (log‐rank test P = 0.034), though duration of DGF was not (P = 0.723). However, multivariable Cox regression analysis found that only acute rejection was independently associated with lower graft survival [HR (95% CI) 4.302 (1.617–11.450); P = 0.003], whereas the presence of DGF and DGF duration were not. In controlled DCD kidney transplantation, DGF duration itself may not be independently associated with graft survival; rather, it may be that acute rejection associated with prolonged DGF is the poor prognostic factor.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Duration of delayed graft function and outcomes after kidney transplantation from controlled donation after circulatory death donors: a retrospective study

et al. 2019

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“…Some studies have stratified DGF recovery according to dialysis duration 9 – 13 . However, the decision to discontinue dialysis after DGF is subjective, and currently, there is a lack of consensus for defining DGF recovery.…”

Section: Introductionmentioning

confidence: 99%

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

Lee

Song

Lee

et al. 2017

Sci Rep

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The effect of delayed graft function (DGF) recovery on long-term graft outcome is unclear. The aim of this study was to examine the association of DGF recovery status with long-term outcome. We analyzed 385 recipients who underwent single kidney transplantation from brain-dead donors between 2004 and 2015. Patients were grouped according to renal function at 1 month post-transplantation: control (without DGF); recovered DGF (glomerular filtration rate [GFR] ≥ 30 mL/min/1.73 m2); and incompletely recovered DGF group (GFR < 30 mL/min/1.73 m2). DGF occurred in 104 of 385 (27%) recipients. Of the DGF patients, 70 recovered from DGF and 34 incompletely recovered from DGF. Death-censored graft survival rates for control, recovered DGF, and incompletely recovered DGF groups were 95.3%, 94.7%, and 80.7%, respectively, at 5 years post-transplantation (P = 0.003). Incompletely recovered DGF was an independent risk factor for death-censored graft loss (HR = 3.410, 95%CI, 1.114-10.437). DGF was associated with increased risk for patient death regardless of DGF recovery status. Mean GFRs at 5 years were 65.5 ± 20.8, 62.2 ± 27.0, and 45.8 ± 15.4 mL/min/1.73 m2 for control, recovered, and incompletely recovered DGF groups, respectively (P < 0.001). Control group and recovered DGF patients had similar renal outcomes. However, DGF was associated with increased risk for patient death regardless of DGF recovery status.

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“…[1][2][3][4][5][6][7][8][9][10][11][12] In recent years, more patients who previously were not considered transplant candidates have been referred for kidney transplant. We reviewed the effects of different factors on development and outcome of early kidney allograft dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: To show the effects of different factors on development and outcome of early kidney allograft dysfunction. Materials and Methods: Two hundred thirty-one kidney transplant recipients were divided into 2 groups: group 1 (125 patients transplanted from 1999-2004) and group 2 (106 patients transplanted from 2008-2013). Age range was 12 to 62 years (group 1) and 7 to 71 years (group 2). Deceaseddonor transplant was more frequent in group 1 (76.8%), and living-donor transplant in group 2 (68.8%). In group 1, transplant was performed for glomerulonephritis or pyelonephritis; in group 2, additional risk factors (18 patients) included diabetes (11 patients), systemic lupus erythematosus (5 patients), amyloidosis (1 patient), and aortic and mitral valve replacement because of bacterial endocarditis (1 patient). In groups 1 and 2, immunosuppression after transplant included cyclosporine, mycophenolate mofetil, and steroids; patients in group 2 also had induction with anti-CD25 monoclonal antibodies. Results: Primary graft function occurred in 89 patients in group 1 (71.2%) and 83 patients in group 2 (78.3%). Immediately after transplant, delayed graft function included anuria, oliguria, adequate amount of urine, and secondary delayed function (several days of polyuria followed by decreased urine output). Ischemia was a leading cause of delayed renal graft function. Anuria after livingdonor transplant was a sign of vascular thrombosis. Rejection was the main cause of secondary delayed graft function, which occurred in only group 1. Survival at 1 year in patients with delayed graft function was 80% in group 1 and 100% in group 2 because of the absence of septic complications. Conclusions: Despite extension of indications, primary functioning of kidney transplants and patient survival increased. Improved care enables long-term rehabilitation of recipients and expanding criteria for kidney transplant.

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The prognostic value of time needed on dialysis in patients with delayed graft function

Abstract: Our study suggests that increased TND is associated with worse CrCl at 1 year. The data also support the hypothesis of a different mechanism for DGF in DCD and non-DCD kidneys.

Cited by 17 publications

References 17 publications

Duration of delayed graft function and outcomes after kidney transplantation from controlled donation after circulatory death donors: a retrospective study

Duration of delayed graft function and outcomes after kidney transplantation from controlled donation after circulatory death donors: a retrospective study

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

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