Delayed graft function: Risk factors, consequences and parameters affecting outcome - Results from MOST, a multinational observational study

被引:46
作者
Lebranchu, Y
Halimi, JM
Bock, A
Chapman, J
Dussol, B
Fritsche, L
Kliem, V
Oppenheimer, F
Pohanka, E
Salvadori, M
Soergel, M
Tufveson, G
机构
[1] CHU Tours, Hop Bretonneau, Tours, France
[2] Kantonsspital, Div Nephrol, Aarau, Switzerland
[3] Westmead Hosp, Westmead, NSW 2145, Australia
[4] Hop Conception, Marseille, France
[5] Charite, Nephrol Klin, Berlin, Germany
[6] Nephrol Zentrum Niedersachsen, Munden, Germany
[7] Hosp Clin Barcelona, Barcelona, Spain
[8] Unitat Transplantament Renal, Tours, France
[9] Univ Vienna, Innere Med Klin, Vienna, Austria
[10] Carreggi Univ Hosp, Florence, Italy
[11] Novartis Pharma, Basel, Switzerland
[12] Univ Uppsala Hosp, Dept Transplantat, Uppsala, Sweden
关键词
POSTTRANSPLANT RENAL-FUNCTION; TRANSPLANT RECIPIENTS; ALLOGRAFT SURVIVAL; REJECTION;
D O I
10.1016/j.transproceed.2004.12.297
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Delayed graft function (DGF) is a common complication after renal transplantation, and may affect graft function. The aim of this analysis was to evaluate risk factors for DGF, as well as parameters and events influencing graft function after DGF We analyzed data collected in an ongoing international, prospective; observational study, the Neoral-MOST (Multinational Observational Study in renal Transplantation), and included in the analysis all patients with cadaveric kidney transplants for whom renal function at 1 year posttransplantation was documented (N = 8950). Logistic regression was used to evaluate the risk factors for DGF occurrence, and multifactorial analysis of variance (ANCOVA) to assess the relevance of different factors for GFR at 1 year. Results. Higher donor age, longer CIT, male recipients, Caucasian recipients, high recipients body mass index, and PRA were all associated with a higher risk for DGF. Renal function of former DGF kidneys at 1 year was lower in kidneys of elder donors, or which had experienced rejection or CMV infection. Variations of the maintenance regimen at 1 year posttransplantation were not associated with better graft function. Multifactorial analysis showed donor age and acute rejection as significant independent factors. Conclusions. Most factors increasing the risk for DGF or having a negative impact on renal function at 1 year in grafts with DGF are predetermined. Additional posttransplant damage by acute rejection was associated with further reductions in GFR. Preventing acute rejection is an important step in achieving optimal function of DGF grafts.
引用
收藏
页码:345 / 347
页数:3
相关论文
共 7 条
[1]  
ANAES (Agence nationale daccreditation et devaluation en sante), 2002, DIAGN INS REN CHRON
[2]   Post-transplant renal function in the first year predicts long-term kidney transplant survival [J].
Hariharan, S ;
McBride, MA ;
Cherikh, WS ;
Tolleris, CB ;
Bresnahan, BA ;
Johnson, CP .
KIDNEY INTERNATIONAL, 2002, 62 (01) :311-318
[3]   Nomogram for predicting the likelihood of delayed graft function in adult cadaveric renal transplant recipients [J].
Irish, WD ;
Mccollum, DA ;
Tesi, RJ ;
Owen, AB ;
Brennan, DC ;
Bailly, JE ;
Schnitzler, MA .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (11) :2967-2974
[4]   Donor age and delayed graft function as predictors of renal allograft survival in rejection-free patients [J].
Moreso, F ;
Serón, D ;
Gil-Vernet, S ;
Riera, L ;
Fulladosa, X ;
Ramos, R ;
Alsina, J ;
Grinyó, JM .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1999, 14 (04) :930-935
[5]   Delayed graft function: Risk factors and implications for renal allograft survival [J].
Ojo, AO ;
Wolfe, RA ;
Held, PJ ;
Port, FK ;
Schmouder, RL .
TRANSPLANTATION, 1997, 63 (07) :968-974
[6]   One-year posttransplant renal function is a strong predictor of long-term kidney function: Results from the neoral-MOST observational study [J].
Salvadori, M ;
Rosati, A ;
Bock, A ;
Chapman, J ;
Dussol, B ;
Fritsche, L ;
Jeffery, J ;
Kliem, V ;
Lebranchu, Y ;
Oppenheimer, F ;
Pohanka, E ;
Tufveson, G .
TRANSPLANTATION PROCEEDINGS, 2003, 35 (08) :2863-2867
[7]   Deleterious effects of delayed graft function in cadaveric renal transplant recipients independent of acute rejection [J].
Shoskes, DA ;
Cecka, JM .
TRANSPLANTATION, 1998, 66 (12) :1697-1701