Exploring the causes of the high incidence of delayed graft function after kidney transplantation in Brazil: a multicenter study.
Tainá Veras de Sanders FreitasMarilda MazzaliRoberto Ceratti ManfroLuis Gustavo Modelli de AndradeAlessandra Rosa VicariMarcos Vinicius de SousaJosé Osmar Medina PestanaValter Duro GarciaDeise Rosa de Boni Monteiro de CarvalhoRonaldo de Matos EsmeraldoClaudia Maria Costa de OliveiraDenise Rodrigues SimãoLuciane Mônica DeboniElias David-NetoFrederico Castelo Branco CavalcantiÁlvaro Pacheco-SilvaGustavo Fernandes FerreiraRafael Lage MadeiraAlexandre Tortoza BignelliGeraldo Sérgio Gonçalves MeiraEuler Pace LasmarElizete KeitelTereza de Azevedo MatuckSilvana Daher da CostaHong Si NgaPaula Frassinetti Castelo Branco Camurça FernandesHumberto Rebello NarcisoMarcos Alexandre VieiraFabiana AgenaIvailda Barbosa FonsecaAna Cristina Carvalho de MatosJuliana BastosSandra Simone VillaçaSilvia Regina HokazonoAlberto Rafael Baleeiro SilvaMarcus LasmarHélio Tedesco Silva-Juniornull nullPublished in: Transplant international : official journal of the European Society for Organ Transplantation (2021)
This retrospective multicenter (n = 18) cohort study evaluated the incidence, risk factors, and the impact of delayed graft function (DGF) on 1-year kidney transplant (KT) outcomes. Of 3992 deceased donor KT performed in 2014-2015, the incidence of DGF was 54%, ranging from 29.9% to 87.7% among centers. Risk factors (lower-bound-95%CI OR upper-bound-95%CI ) were male gender (1.066 1.2491.463 ), diabetic kidney disease (1.053 1.2961.595 ), time on dialysis (1.005 1.0071.009 ), retransplantation (1.035 1.3971.885 ), preformed anti-HLA antibodies (1.011 1.3831.892 ), HLA mismatches (1.006 1.0661.130 ), donor age (1.011 1.0171.023 ), donor final serum creatinine (sCr) (1.239 1.3171.399 ), cold ischemia time (CIT) (1.031 1.0431.056 ), machine perfusion (0.401 0.5420.733 ), and induction therapy with rabbit antithymocyte globulin (rATG) (0.658 0.8000.973 ). Duration of DGF > 4 days was associated with inferior renal function and DGF > 14 days with the higher incidences of acute rejection, graft loss, and death. In conclusion, the incidence and duration of DGF were high and associated with inferior graft outcomes. While late referral and poor donor maintenance account for the high overall incidence of DGF, variability in donor and recipient selection, organ preservation method, and type of induction agent may account for the wide variation observed among transplant centers.
Keyphrases
- risk factors
- type diabetes
- primary care
- chronic kidney disease
- cross sectional
- magnetic resonance
- liver failure
- skeletal muscle
- machine learning
- adipose tissue
- intensive care unit
- mesenchymal stem cells
- deep learning
- metabolic syndrome
- computed tomography
- acute respiratory distress syndrome
- smoking cessation
- uric acid
- respiratory failure