Pande Made Wisnu Tirtayasa , Gerhard Reinaldi Situmorang , Gede Wirya Kusuma Duarsa , Gede Wira Mahadita , Tanaya Ghinorawa , Etriyel Myh , Eriawan Agung Nugroho , Yenny Kandarini , Arry Rodjani , Nur Rasyid
{"title":"活体肾移植后移植功能延迟的风险因素：荟萃分析","authors":"Pande Made Wisnu Tirtayasa , Gerhard Reinaldi Situmorang , Gede Wirya Kusuma Duarsa , Gede Wira Mahadita , Tanaya Ghinorawa , Etriyel Myh , Eriawan Agung Nugroho , Yenny Kandarini , Arry Rodjani , Nur Rasyid","doi":"10.1016/j.trim.2024.102094","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Delayed graft function (DGF) is a common condition that necessitates dialysis during the first week after transplantation. Although DGF rarely occurs following living-donor kidney transplantation (LDKT), it may eventually lead to acute or chronic graft rejection. This study aimed to assess the risk factors for DGF in patients who underwent LDKT.</p></div><div><h3>Methods</h3><p>A systematic review and meta-analysis of studies published before August 2022 was conducted using the PubMed, Science Direct, Cochrane, and Directory of Open Access Journal (DOAJ) databases. The review included studies that assessed the incidence of DGF following LDKT, and examined its risk factors, while excluding studies involving deceased donors. Potential risk factors were analyzed using pooled mean differences or odds ratios with 95% confidence intervals (CIs). Review Manager 5.3 was used for the meta-analysis.</p></div><div><h3>Results</h3><p>Among the 13 included studies, 3685 cases of DGF were identified in a total of 113,261 patients (3.25%). Potential risk factors for DGF following LDKT were examined across several aspects, including donor, recipient, donor/recipient relationship, and immunological and intraoperative factors. The identified risk factors included older donors (<em>P</em> = 0.07), male recipients (<em>P</em> < 0.0001), higher recipient body mass index (BMI) (<em>P</em> < 0.0001), non-white recipients (<em>P</em> < 0.0001), pre-existing diabetes (<em>P</em> < 0.0001), pre-existing hypertension (<em>P</em> = 0.01), history of dialysis (<em>P</em> < 0.0001), re-transplantation (<em>P</em> = 0.004), unrelated donor/recipient (<em>P</em> = 0.02), ABO incompatibility (<em>P</em> < 0.0001), higher panel reactive antibody (PRA) levels (<em>P</em> < 0.0001), utilization of right kidney (<em>P</em> < 0.0001), and longer cold ischemia time (CIT) (<em>P</em> = 0.004).</p></div><div><h3>Conclusion</h3><p>Several factors related to the donor, recipient, donor/recipient relationship, and immunological and intraoperative aspects were identified as potential risk factors for the development of DGF following LDKT. Addressing and optimizing these factors may improve the long-term outcomes of LDKT.</p></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"86 ","pages":"Article 102094"},"PeriodicalIF":1.6000,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk factors of delayed graft function following living donor kidney transplantation: A meta-analysis\",\"authors\":\"Pande Made Wisnu Tirtayasa , Gerhard Reinaldi Situmorang , Gede Wirya Kusuma Duarsa , Gede Wira Mahadita , Tanaya Ghinorawa , Etriyel Myh , Eriawan Agung Nugroho , Yenny Kandarini , Arry Rodjani , Nur Rasyid\",\"doi\":\"10.1016/j.trim.2024.102094\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Delayed graft function (DGF) is a common condition that necessitates dialysis during the first week after transplantation. Although DGF rarely occurs following living-donor kidney transplantation (LDKT), it may eventually lead to acute or chronic graft rejection. This study aimed to assess the risk factors for DGF in patients who underwent LDKT.</p></div><div><h3>Methods</h3><p>A systematic review and meta-analysis of studies published before August 2022 was conducted using the PubMed, Science Direct, Cochrane, and Directory of Open Access Journal (DOAJ) databases. The review included studies that assessed the incidence of DGF following LDKT, and examined its risk factors, while excluding studies involving deceased donors. Potential risk factors were analyzed using pooled mean differences or odds ratios with 95% confidence intervals (CIs). Review Manager 5.3 was used for the meta-analysis.</p></div><div><h3>Results</h3><p>Among the 13 included studies, 3685 cases of DGF were identified in a total of 113,261 patients (3.25%). Potential risk factors for DGF following LDKT were examined across several aspects, including donor, recipient, donor/recipient relationship, and immunological and intraoperative factors. The identified risk factors included older donors (<em>P</em> = 0.07), male recipients (<em>P</em> < 0.0001), higher recipient body mass index (BMI) (<em>P</em> < 0.0001), non-white recipients (<em>P</em> < 0.0001), pre-existing diabetes (<em>P</em> < 0.0001), pre-existing hypertension (<em>P</em> = 0.01), history of dialysis (<em>P</em> < 0.0001), re-transplantation (<em>P</em> = 0.004), unrelated donor/recipient (<em>P</em> = 0.02), ABO incompatibility (<em>P</em> < 0.0001), higher panel reactive antibody (PRA) levels (<em>P</em> < 0.0001), utilization of right kidney (<em>P</em> < 0.0001), and longer cold ischemia time (CIT) (<em>P</em> = 0.004).</p></div><div><h3>Conclusion</h3><p>Several factors related to the donor, recipient, donor/recipient relationship, and immunological and intraoperative aspects were identified as potential risk factors for the development of DGF following LDKT. Addressing and optimizing these factors may improve the long-term outcomes of LDKT.</p></div>\",\"PeriodicalId\":23304,\"journal\":{\"name\":\"Transplant immunology\",\"volume\":\"86 \",\"pages\":\"Article 102094\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-07-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplant immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0966327424001102\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant immunology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966327424001102","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Risk factors of delayed graft function following living donor kidney transplantation: A meta-analysis
Introduction
Delayed graft function (DGF) is a common condition that necessitates dialysis during the first week after transplantation. Although DGF rarely occurs following living-donor kidney transplantation (LDKT), it may eventually lead to acute or chronic graft rejection. This study aimed to assess the risk factors for DGF in patients who underwent LDKT.
Methods
A systematic review and meta-analysis of studies published before August 2022 was conducted using the PubMed, Science Direct, Cochrane, and Directory of Open Access Journal (DOAJ) databases. The review included studies that assessed the incidence of DGF following LDKT, and examined its risk factors, while excluding studies involving deceased donors. Potential risk factors were analyzed using pooled mean differences or odds ratios with 95% confidence intervals (CIs). Review Manager 5.3 was used for the meta-analysis.
Results
Among the 13 included studies, 3685 cases of DGF were identified in a total of 113,261 patients (3.25%). Potential risk factors for DGF following LDKT were examined across several aspects, including donor, recipient, donor/recipient relationship, and immunological and intraoperative factors. The identified risk factors included older donors (P = 0.07), male recipients (P < 0.0001), higher recipient body mass index (BMI) (P < 0.0001), non-white recipients (P < 0.0001), pre-existing diabetes (P < 0.0001), pre-existing hypertension (P = 0.01), history of dialysis (P < 0.0001), re-transplantation (P = 0.004), unrelated donor/recipient (P = 0.02), ABO incompatibility (P < 0.0001), higher panel reactive antibody (PRA) levels (P < 0.0001), utilization of right kidney (P < 0.0001), and longer cold ischemia time (CIT) (P = 0.004).
Conclusion
Several factors related to the donor, recipient, donor/recipient relationship, and immunological and intraoperative aspects were identified as potential risk factors for the development of DGF following LDKT. Addressing and optimizing these factors may improve the long-term outcomes of LDKT.
期刊介绍：
Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.
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