Kidney Delayed Graft Function in Simultaneous Pancreas-Kidney Transplant Recipients Is Associated With Inferior Outcomes.

IF 1.9 Q3 TRANSPLANTATION
Transplantation Direct Pub Date : 2025-04-17 eCollection Date: 2025-05-01 DOI:10.1097/TXD.0000000000001797
Sofia Nehring Firmino, Ekaterina Fedorova, Eman A Alshaikh, Dixon Kaufman, Jon Odorico, Didier Mandelbrot, Brad C Astor, Sandesh Parajuli
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引用次数: 0

Abstract

Background: Kidney delayed graft function (K-DGF) is associated with worse outcomes in simultaneous pancreas-kidney (SPK) recipients. However, its potential association with specific infections, rejection, and early complications remains unclear.

Methods: We compared recipients with K-DGF to those without K-DGF among all adult SPK recipients transplanted at our center between January 2000 and December 2022 who had >2 wk of pancreas graft survival. Outcomes of interest included common posttransplant infections, including urinary tract infection (UTI), pneumonia, cytomegalovirus, BK, surgical wound infection, infected intra-abdominal fluid collection, graft rejection, and death-censored graft failure (DCGF) within the first year of transplant. We also looked for the need for early laparotomy within 90 d.

Results: Seven hundred sixty-five SPK recipients were included, of whom 85 (11.1%) developed K-DGF. In Cox regression analysis, after adjustment for multiple key variables, K-DGF was associated/related with increased risk for UTI (adjusted hazard ratio [aHR], 1.76; 95% confidence interval [CI], 1.06-0.94; P = 0.03), infected intra-abdominal fluid collection (aHR, 2.14; 95% CI, 1.13-4.04; P = 0.02), and need for relaparotomy within 90 d (aHR, 2.07; 95% CI, 1.27-3.37; P = 0.003). K-DGF was also associated with increased risk for pancreas DCGF (aHR, 4.88; 95% CI, 1.90-12.51; P < 0.001). K-DGF was not associated with risk for other common infections of interest or graft rejection.

Conclusions: K-DGF among SPK recipients is associated with an increased risk of UTI, infected intra-abdominal fluid collection, and the need for early relaparotomy, along with pancreas DCGF. Close monitoring and appropriate management are warranted in this higher-risk patient population.

胰肾联合移植受者肾移植功能延迟与预后不良相关
背景:肾移植延迟功能(K-DGF)与同时胰肾移植(SPK)受者较差的预后相关。然而,其与特异性感染、排斥反应和早期并发症的潜在关联尚不清楚。方法:我们比较了2000年1月至2022年12月期间在我们中心移植的所有成年SPK受体中接受K-DGF和未接受K-DGF的受体,这些受体的胰腺移植存活时间为12周。研究结果包括常见的移植后感染,包括尿路感染(UTI)、肺炎、巨细胞病毒、BK、手术伤口感染、腹腔积液感染、移植物排斥反应和移植后一年内死亡审查的移植物衰竭(DCGF)。结果:纳入765例SPK受者,其中85例(11.1%)发展为K-DGF。在Cox回归分析中,在对多个关键变量进行校正后,K-DGF与UTI风险增加相关(校正风险比[aHR], 1.76;95%置信区间[CI], 1.06-0.94;P = 0.03),腹腔内积液感染(aHR, 2.14;95% ci, 1.13-4.04;P = 0.02),需要在90 d内进行剖腹手术(aHR, 2.07;95% ci, 1.27-3.37;p = 0.003)。K-DGF也与胰腺DCGF风险增加相关(aHR, 4.88;95% ci, 1.90-12.51;结论:SPK受者的K-DGF与尿路感染风险增加、腹腔内液体收集感染、早期开腹手术的需要以及胰腺DCGF相关。在这一高危人群中,密切监测和适当管理是必要的。
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来源期刊
Transplantation Direct
Transplantation Direct TRANSPLANTATION-
CiteScore
3.40
自引率
4.30%
发文量
193
审稿时长
8 weeks
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