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Risk factors and outcomes of prolonged recovery from delayed graft function after deceased kidney transplantation.

Authors
  • Zhang, Huanxi1
  • Fu, Qian1
  • Liu, Jinqi2
  • Li, Jun1
  • Deng, Ronghai1
  • Wu, Chenglin1
  • Nie, Weijian1
  • Chen, Xutao1
  • Liu, Longshan1, 3, 4
  • Wang, Changxi1, 3, 4
  • 1 Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. , (China)
  • 2 Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China. , (China)
  • 3 Guangdong Provincial Key Laboratory on Organ Donation and Transplant Immunology, Guangzhou, China. , (China)
  • 4 Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China. , (China)
Type
Published Article
Journal
Renal Failure
Publisher
Informa UK (Taylor & Francis)
Publication Date
Nov 01, 2020
Volume
42
Issue
1
Pages
792–798
Identifiers
DOI: 10.1080/0886022X.2020.1803084
PMID: 32772773
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We aimed to evaluate the effect of prolonged recovery from DGF on outcomes, using a new definition of DGF recovery time, among deceased donor kidney transplant recipients with DGF, and to examine the risk factors for prolonged recovery. From 2007 to 2016, 91 deceased donor kidney transplant recipients with DGF were retrospectively analyzed. DGF recovery time was defined as the time from transplantation to achieve a stable estimated glomerular filtration rate (eGFR). Recipients with a DGF recovery time greater than or equal to the median were assigned to the prolonged recovery group, while the others were assigned to the rapid recovery group. The median DGF recovery time was 27 days. Donor terminal eGFR was significantly lower in the prolonged recovery group (n = 46) compared with the rapid recovery group (n = 45) (median 24.9 vs. 65.4 ml/min/1.73m2, p = 0.004). The eGFR at 1 year post-transplant in the prolonged recovery group was significantly lower than that in the rapid recovery group (50.6 ± 20.0 vs. 63.5 ± 21.4 ml/min/1.73m2, p = 0.005). The risk of adverse outcomes (acute rejection, pneumonia, graft failure, and death) was significantly greater in the prolonged recovery group (hazard ratio 2.604, 95% confidence interval 1.102-6.150, p = 0.029) compared with the rapid recovery group. Decreased donor terminal eGFR is a risk factor for prolonged recovery from DGF after deceased kidney transplantation. Prolonged DGF recovery time is associated with reduced graft function at 1-year post-transplant, and poor transplant outcome.

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