Journal of Transplantation最新文献_第9页

Breakdown in the organ donation process and its effect on organ availability. 器官捐献过程中的故障及其对器官可用性的影响。

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-04-09 DOI: 10.1155/2015/831501

Manik Razdan, Howard B Degenholtz, Jeremy M Kahn, Julia Driessen

{"title":"Breakdown in the organ donation process and its effect on organ availability.","authors":"Manik Razdan, Howard B Degenholtz, Jeremy M Kahn, Julia Driessen","doi":"10.1155/2015/831501","DOIUrl":"https://doi.org/10.1155/2015/831501","url":null,"abstract":"Background. This study examines the effect of breakdown in the organ donation process on the availability of transplantable organs. A process breakdown is defined as a deviation from the organ donation protocol that may jeopardize organ recovery. Methods. A retrospective analysis of donation-eligible decedents was conducted using data from an independent organ procurement organization. Adjusted effect of process breakdown on organs transplanted from an eligible decedent was examined using multivariable zero-inflated Poisson regression. Results. An eligible decedent is four times more likely to become an organ donor when there is no process breakdown (adjusted OR: 4.01; 95% CI: 1.6838, 9.6414; P < 0.01) even after controlling for the decedent's age, gender, race, and whether or not a decedent had joined the state donor registry. However once the eligible decedent becomes a donor, whether or not there was a process breakdown does not affect the number of transplantable organs yielded. Overall, for every process breakdown occurring in the care of an eligible decedent, one less organ is available for transplant. Decedent's age is a strong predictor of likelihood of donation and the number of organs transplanted from a donor. Conclusion. Eliminating breakdowns in the donation process can potentially increase the number of organs available for transplant but some organs will still be lost. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"831501"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/831501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33156690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Proximal Tubular Injury in Medullary Rays Is an Early Sign of Acute Tacrolimus Nephrotoxicity. 髓质射线近端肾小管损伤是急性他克莫司肾毒性的早期征象。

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-06-24 DOI: 10.1155/2015/142521

Diane Cosner, Xu Zeng, Ping L Zhang

{"title":"Proximal Tubular Injury in Medullary Rays Is an Early Sign of Acute Tacrolimus Nephrotoxicity.","authors":"Diane Cosner, Xu Zeng, Ping L Zhang","doi":"10.1155/2015/142521","DOIUrl":"https://doi.org/10.1155/2015/142521","url":null,"abstract":"Tacrolimus (FK506) is one of the principal immunosuppressive agents used after solid organ transplantations to prevent allograft rejection. Chronic renal injury induced by tacrolimus is characterized by linear fibrosis in the medullary rays; however, the early morphologic findings of acute tacrolimus nephrotoxicity are not well characterized. Kidney injury molecule-1 (KIM-1) is a specific injury biomarker that has been proven to be useful in the diagnosis of mild to severe acute tubular injury on renal biopsies. This study was motivated by a patient with acute kidney injury associated with elevated serum tacrolimus levels in whom KIM-1 staining was present only in proximal tubules located in the medullary rays in the setting of otherwise normal light, immunofluorescent, and electron microscopy. We subsequently evaluated KIM-1 expression in 45 protocol and 39 indicated renal transplant biopsies to determine whether higher serum levels of tacrolimus were associated with acute segment specific injury to the proximal tubule, as reflected by KIM-1 staining in the proximal tubules of the cortical medullary rays. The data suggest that tacrolimus toxicity preferentially affects proximal tubules in medullary rays and that this targeted injury is a precursor lesion for the linear fibrosis seen in chronic tacrolimus toxicity. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"142521"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/142521","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34028448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Factors Associated with Uncontrolled Hypertension among Renal Transplant Recipients Attending Nephrology Clinics in Nairobi, Kenya. 在肯尼亚内罗毕肾病诊所就诊的肾移植受者中与未控制的高血压有关的因素。

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-07-14 DOI: 10.1155/2015/746563

Mary N Kubo, Joshua K Kayima, Anthony J Were, Seth O McLigeyo, Elijah N Ogola

{"title":"Factors Associated with Uncontrolled Hypertension among Renal Transplant Recipients Attending Nephrology Clinics in Nairobi, Kenya.","authors":"Mary N Kubo, Joshua K Kayima, Anthony J Were, Seth O McLigeyo, Elijah N Ogola","doi":"10.1155/2015/746563","DOIUrl":"10.1155/2015/746563","url":null,"abstract":"Objective. To determine the factors associated with poor blood pressure control among renal transplant recipients in a resource-limited setting. Methods. A cross-sectional study was carried out on renal transplant recipients at the Kenyatta National Hospital. Sociodemographic details, blood pressure, urine albumin : creatinine ratio, and adherence using the MMAS-8 questionnaire were noted. Independent factors associated with uncontrolled hypertension were determined using logistic regression analysis. Results. 85 subjects were evaluated. Mean age was 42.4 (SD ± 12.2) years, with a male : female ratio of 1.9 : 1. Fifty-five patients (64.7%) had uncontrolled hypertension (BP ≥ 130/80 mmHg). On univariate analysis, male sex (OR 3.7, 95% CI 1.4-9.5, p = 0.006), higher levels of proteinuria (p = 0.042), and nonadherence to antihypertensives (OR 18, 95% CI 5.2-65.7, p < 0.001) were associated with uncontrolled hypertension. On logistic regression analysis, male sex (adjusted OR 4.6, 95% CI 1.1-19.0, p = 0.034) and nonadherence (adjusted OR 33.8, 95% CI 8.6-73.0, p < 0.001) were independently associated with uncontrolled hypertension. Conclusion. Factors associated with poor blood pressure control in this cohort were male sex and nonadherence to antihypertensives. Emphasis on adherence to antihypertensive therapy must be pursued within this population. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"746563"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34077447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The benefit of sirolimus maintenance immunosuppression and rabbit antithymocyte globulin induction in liver transplant recipients that develop acute kidney injury in the early postoperative period. 西罗莫司维持免疫抑制和兔抗胸腺细胞球蛋白诱导对术后早期发生急性肾损伤的肝移植受者的益处

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-03-11 DOI: 10.1155/2015/926168

Benjamin T Duhart, Winston A Ally, Amy G Krauss, Joanna Q Hudson, James D Eason, Vinaya Rao, Jason M Vanatta

{"title":"The benefit of sirolimus maintenance immunosuppression and rabbit antithymocyte globulin induction in liver transplant recipients that develop acute kidney injury in the early postoperative period.","authors":"Benjamin T Duhart, Winston A Ally, Amy G Krauss, Joanna Q Hudson, James D Eason, Vinaya Rao, Jason M Vanatta","doi":"10.1155/2015/926168","DOIUrl":"https://doi.org/10.1155/2015/926168","url":null,"abstract":"Published data are limited describing renal outcomes in orthotopic liver transplant (OLT) recipients prescribed sirolimus (SRL) maintenance immunosuppression (MIS) and rabbit antithymocyte globulin (rATG) induction. We investigated whether SRL MIS and rATG induction facilitated recovery of acute kidney injury in the early postoperative period. This retrospective descriptive study screened 308 consecutive OLTs performed between 2006 and 2009. All patients received rATG induction with steroid avoidance. MIS consisted of SRL or TAC with mycophenolate mofetil. A total of 197 patients were included: 168 (85%) received TAC and 29 (15%) received SRL for a median of 365 days. Demographics were similar between groups except for a higher incidence of pretransplant renal dysfunction in the SRL recipients (SRL 59% versus TAC 21%; P < 0.05). The eGFR was significantly (P < 0.05) higher for all time points in the TAC group with the exception of month 2. However, improvement in eGFR was significantly (P < 0.05) greater in the SRL group postoperatively. Our study suggests that rATG induction and SRL maintenance immunosuppression facilitate renal recovery for liver transplant recipients that develop acute kidney injury in the early postoperative period. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"926168"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/926168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33206459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A Nationwide Assessment of the Burden of Urinary Tract Infection among Renal Transplant Recipients. 肾移植受者尿路感染负担的全国评估。

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-02-25 DOI: 10.1155/2015/854640

Benjamin J Becerra, Monideepa B Becerra, Nasia Safdar

{"title":"A Nationwide Assessment of the Burden of Urinary Tract Infection among Renal Transplant Recipients.","authors":"Benjamin J Becerra, Monideepa B Becerra, Nasia Safdar","doi":"10.1155/2015/854640","DOIUrl":"https://doi.org/10.1155/2015/854640","url":null,"abstract":"Objective. Evaluate the prevalence and outcomes of urinary tract infection (UTI) among renal transplant recipients. Methods. A secondary analysis of the Nationwide Inpatient Sample 2009–2011 was conducted. Survey-weighted multivariable regression analyses were used to examine the impact of UTI on transplant complications, total charges, and length of stay. Results. A total of 1,044 renal transplant recipients, representing a population estimate of 49,862, were included in the study. UTI was most common in transplant recipients with hypertension (53%) and prevalence was noted to be 28.2 and 65.9 cases per 1,000 for men and women, respectively. UTI increased the likelihood of transplant complications (182% for men, 169% for women). Total charges were 28% higher among men as compared to 22% among women with UTI. Such infection also increased the length of stay by 87% among men and 74% among women. Discussion. UTI in renal transplant recipients was associated with prolonged length of stay, total charges, and increased odds of transplant complications. Interventions to prevent UTI among such patients should be a priority area for future research and practice.","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"854640"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/854640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33164185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

MicroRNAs in Kidney Transplantation: Living up to Their Expectations? microrna在肾移植中的应用:达到预期?

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-05-11 DOI: 10.1155/2015/354826

Eline K van den Akker, Frank J M F Dor, Jan N M IJzermans, Ron W F de Bruin

{"title":"MicroRNAs in Kidney Transplantation: Living up to Their Expectations?","authors":"Eline K van den Akker, Frank J M F Dor, Jan N M IJzermans, Ron W F de Bruin","doi":"10.1155/2015/354826","DOIUrl":"https://doi.org/10.1155/2015/354826","url":null,"abstract":"Since the discovery of microRNAs, ample research has been conducted to elucidate their involvement in an array of (patho)physiological conditions. Ischemia reperfusion injury is a major problem in kidney transplantation and its mechanism is still not fully known, nor is there an effective therapy. Furthermore, no biomarker is available to specifically measure (ischemic) damage after kidney transplantation or predict transplantation outcome. In this review, we summarize studies conducted on microRNAs in renal ischemia reperfusion injury and kidney transplantation. Although the number of publications on miRNAs in different areas of nephrology is increasing every year, only a limited number of reports that address the role of miRNAs in relation to ischemia reperfusion injury or kidney transplantation are available. All reports up to June 2014 on microRNAs in renal IRI, kidney transplantation, and renal allograft status were included. Design of the studies was highly variable and there was limited overlap between microRNAs found in these reports. No single microRNA expression pattern could be found, although multiple microRNAs involved in the immune response seem to be altered after ischemia reperfusion injury and kidney transplantation. Although there is a growing interest in microRNA research in kidney transplantation aiming to identify biomarkers and therapeutical targets, to date, no specific microRNA has been demonstrated to be applicable as either one, mostly because of lack of specificity. More systematical research is needed to determine whether microRNAs can be applied as biomarker, therapeutic target, or therapeutic agent in kidney transplantation. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"354826"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/354826","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33272355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany. 德国死亡供体和移植前受体参数对早期肾移植总存活率的影响

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-10-11 DOI: 10.1155/2015/307230

Carl-Ludwig Fischer-Fröhlich, Marcus Kutschmann, Johanna Feindt, Irene Schmidtmann, Günter Kirste, Nils R Frühauf, Ulrike Wirges, Axel Rahmel, Christina Schleicher

{"title":"Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany.","authors":"Carl-Ludwig Fischer-Fröhlich, Marcus Kutschmann, Johanna Feindt, Irene Schmidtmann, Günter Kirste, Nils R Frühauf, Ulrike Wirges, Axel Rahmel, Christina Schleicher","doi":"10.1155/2015/307230","DOIUrl":"10.1155/2015/307230","url":null,"abstract":"Background. Scarcity of grafts for kidney transplantation (KTX) caused an increased consideration of deceased donors with substantial risk factors. There is no agreement on which ones are detrimental for overall graft-survival. Therefore, we investigated in a nationwide multicentre study the impact of donor and recipient related risks known before KTX on graft-survival based on the original data used for allocation and graft acceptance. Methods. A nationwide deidentified multicenter study-database was created of data concerning kidneys donated and transplanted in Germany between 2006 and 2008 as provided by the national organ procurement organization (Deutsche Stiftung Organtransplantation) and BQS Institute. Multiple Cox regression (significance level 5%, hazard ratio [95% CI]) was conducted (n = 4411, isolated KTX). Results. Risk factors associated with graft-survival were donor age (1.020 [1.013-1.027] per year), donor size (0.985 [0.977-0.993] per cm), donor's creatinine at admission (1.002 [1.001-1.004] per µmol/L), donor treatment with catecholamine (0.757 [0.635-0.901]), and reduced graft-quality at procurement (1.549 [1.217-1.973]), as well as recipient age (1.012 [1.003-1.021] per year), actual panel reactive antibodies (1.007 [1.002-1.011] per percent), retransplantation (1.850 [1.484-2.306]), recipient's cardiovascular comorbidity (1.436 [1.212-1.701]), and use of IL2-receptor antibodies for induction (0.741 [0.619-0.887]). Conclusion. Some donor characteristics persist to impact graft-survival (e.g., age) while the effect of others could be mitigated by elaborate donor-recipient match and care. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 1","pages":"307230"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64896509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alternative Living Kidney Donation Programs Boost Genetically Unrelated Donation. 替代活体肾脏捐赠计划促进基因无关捐赠。

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-09-02 DOI: 10.1155/2015/748102

Rosalie A Poldervaart, Mirjam Laging, Tessa Royaards, Judith A Kal-van Gestel, Madelon van Agteren, Marry de Klerk, Willij Zuidema, Michiel G H Betjes, Joke I Roodnat

{"title":"Alternative Living Kidney Donation Programs Boost Genetically Unrelated Donation.","authors":"Rosalie A Poldervaart, Mirjam Laging, Tessa Royaards, Judith A Kal-van Gestel, Madelon van Agteren, Marry de Klerk, Willij Zuidema, Michiel G H Betjes, Joke I Roodnat","doi":"10.1155/2015/748102","DOIUrl":"https://doi.org/10.1155/2015/748102","url":null,"abstract":"Donor-recipient ABO and/or HLA incompatibility used to lead to donor decline. Development of alternative transplantation programs enabled transplantation of incompatible couples. How did that influence couple characteristics? Between 2000 and 2014, 1232 living donor transplantations have been performed. In conventional and ABO-incompatible transplantation the willing donor becomes an actual donor for the intended recipient. In kidney-exchange and domino-donation the donor donates indirectly to the intended recipient. The relationship between the donor and intended recipient was studied. There were 935 conventional and 297 alternative program transplantations. There were 66 ABO-incompatible, 68 domino-paired, 62 kidney-exchange, and 104 altruistic donor transplantations. Waiting list recipients (n = 101) were excluded as they did not bring a living donor. 1131 couples remained of whom 196 participated in alternative programs. Genetically unrelated donors (486) were primarily partners. Genetically related donors (645) were siblings, parents, children, and others. Compared to genetically related couples, almost three times as many genetically unrelated couples were incompatible and participated in alternative programs (P < 0.001). 62% of couples were genetically related in the conventional donation program versus 32% in alternative programs (P < 0.001). Patient and graft survival were not significantly different between recipient programs. Alternative donation programs increase the number of transplantations by enabling genetically unrelated donors to donate. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"748102"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/748102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34116344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Boceprevir-Based Triple Antiviral Therapy for Chronic Hepatitis C Virus Infection in Kidney-Transplant Candidates. 基于boceprevir的三联抗病毒治疗肾移植候选者慢性丙型肝炎病毒感染

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-07-16 DOI: 10.1155/2015/159795

Mireille Mehawej, Lionel Rostaing, Laurent Alric, Arnaud Del Bello, Jacques Izopet, Nassim Kamar

{"title":"Boceprevir-Based Triple Antiviral Therapy for Chronic Hepatitis C Virus Infection in Kidney-Transplant Candidates.","authors":"Mireille Mehawej, Lionel Rostaing, Laurent Alric, Arnaud Del Bello, Jacques Izopet, Nassim Kamar","doi":"10.1155/2015/159795","DOIUrl":"https://doi.org/10.1155/2015/159795","url":null,"abstract":"Background. There are few data on the combination of (pegylated-) interferon- (Peg-IFN-) α, ribavirin, and first-generation direct-acting antiviral agents (DAAs). Our aim was to describe the efficacy and safety of Peg-IFN-α, ribavirin, and boceprevir in hemodialysis patients. Patients. Six hemodialysis patients, chronically infected by genotype-1 HCV, were given Peg-IFN-α (135 µg/week), ribavirin (200 mg/d), and boceprevir (2400 mg/d) for 48 weeks. Results. At initiation of antiviral therapy, median viral concentration was 5.68 (3.78-6.55) log IU/mL. HCV RNA was undetectable in four of the six patients at week 4 and in all patients at week 24. A breakthrough was observed in two patients between weeks 24 and 48, and a third patient stopped antiviral therapy between weeks 24 and 48 because of severe peripheral neuropathy. At week 48, HCV RNA was undetectable in three patients. Of these, two patients relapsed within a month after antiviral therapy was stopped. Hence, only one patient had a sustained virological response; he was a previous partial responder. Overall, anemia was the main side effect. Conclusion. A triple antiviral therapy based on Peg-IFN-α, ribavirin, and boceprevir is not optimal at treating hemodialysis patients with chronic HCV infection. Studies using new-generation drugs are required in this setting. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"159795"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/159795","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34077446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Delayed Graft Function in Kidney Transplants: Time Evolution, Role of Acute Rejection, Risk Factors, and Impact on Patient and Graft Outcome. 肾移植中的移植物功能延迟：时间演变、急性排斥反应的作用、风险因素以及对患者和移植物结果的影响。

IF 2.5

Journal of Transplantation Pub Date : 2015-01-01 Epub Date: 2015-09-10 DOI: 10.1155/2015/163757

Martin Chaumont, Judith Racapé, Nilufer Broeders, Fadoua El Mountahi, Annick Massart, Thomas Baudoux, Jean-Michel Hougardy, Dimitri Mikhalsky, Anwar Hamade, Alain Le Moine, Daniel Abramowicz, Pierre Vereerstraeten

{"title":"Delayed Graft Function in Kidney Transplants: Time Evolution, Role of Acute Rejection, Risk Factors, and Impact on Patient and Graft Outcome.","authors":"Martin Chaumont, Judith Racapé, Nilufer Broeders, Fadoua El Mountahi, Annick Massart, Thomas Baudoux, Jean-Michel Hougardy, Dimitri Mikhalsky, Anwar Hamade, Alain Le Moine, Daniel Abramowicz, Pierre Vereerstraeten","doi":"10.1155/2015/163757","DOIUrl":"10.1155/2015/163757","url":null,"abstract":"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. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2015 ","pages":"163757"},"PeriodicalIF":2.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34242864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0