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2015 ; 2015
(ä): 163757
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English Wikipedia
Delayed Graft Function in Kidney Transplants: Time Evolution, Role of Acute
Rejection, Risk Factors, and Impact on Patient and Graft Outcome
#MMPMID26448870
Chaumont M
; Racapé J
; Broeders N
; El Mountahi F
; Massart A
; Baudoux T
; Hougardy JM
; Mikhalsky D
; Hamade A
; Le Moine A
; Abramowicz D
; Vereerstraeten P
J Transplant
2015[]; 2015
(ä): 163757
PMID26448870
show ga
Background. Although numerous risk factors for delayed graft function (DGF) have
been identified, the role of ischemia-reperfusion injury and acute rejection
episodes (ARE) occurring during the DGF period is ill-defined and DGF impact on
patient and graft outcome remains controversial. Methods. From 1983 to 2014, 1784
kidney-only transplantations from deceased donors were studied. Classical risk
factors for DGF along with two novel ones, recipient's perioperative saline
loading and residual diuresis, were analyzed by logistic regression and receiver
operating characteristic (ROC) curves. Results. Along with other risk factors,
absence of perioperative saline loading increases acute rejection incidence (OR =
1.9 [1.2-2.9]). Moreover, we observed two novel risk factors for DGF: patient's
residual diuresis ?500?mL/d (OR = 2.3 [1.6-3.5]) and absence of perioperative
saline loading (OR = 3.3 [2.0-5.4]). Area under the curve of the ROC curve (0.77
[0.74-0.81]) shows an excellent discriminant power of our model, irrespective of
rejection. DGF does not influence patient survival (P = 0.54). However, graft
survival is decreased only when rejection was associated with DGF (P <
0.001).??Conclusions. Perioperative saline loading efficiently prevents
ischemia-reperfusion injury, which is the predominant factor inducing DGF. DGF
per se has no influence on patient and graft outcome. Its incidence is currently
close to 5% in our centre.