Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome.
Abstract. Delayed graft function (DGF) remains a grieving complication after renal transplantation. In this study, we examined various factors related to organ donation, transport, and transplantation for their influence on the incidence of DGF and on long-term prognosis. The incidence of DGF, renal function after 5 years, and allograft survival were analyzed in 200 kidneys transplanted in Düsseldorf as well as in 193 partner kidneys transplanted at 43 other centers. The main risk factors for DGF were donor age, cold ischemia time (CIT) and organ shipment. DGF itself, as well as donor age, influenced the long term prognosis. A significant relationship between the partner organs regarding clinical outcome was demonstrated. Non-immunological factors strongly influence the clinical results after renal transplantation. Organs of older donors have a limited long-term prognosis. To minimize additional risks, prevention of DGF, especially by reducing CIT, should be regarded as of paramount importance.
Hetzel
Gerd Rüdiger
GR
Klinik für Nephrologie und Rheumatologie, Universitätsklinikum, Heinrich Heine Universität, Moorenstrasse 5, 40225 Düsseldorf, Germany. hetzel@med.uni-duesseldorf.de
Klein
Barbara
B
Brause
Matthias
M
Westhoff
Andreas
A
Willers
Reinhart
R
Sandmann
Wilhelm
W
Grabensee
Bernd
B
D000328:Adult; D000367:Age Factors; D000368:Aged; D002102:Cadaver; D003080:Cold Temperature; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D015994:Incidence; D007511:Ischemia / Q000150:complications; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology* / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods / Q000502:physiology* / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome