Predictive characteristics of delayed graft function after expanded and standard criteria donor kidney transplantations.
Delayed graft function (DGF) represents one of the most common complications after kidney transplantation. The increased use of expanded criteria donors (ECD) is related to a greater risk for DGF. The objective of our study was to analyze the incidence of DGF among ECD versus standard criteria donors (SCD). Among 121 cases we obtained 2 groups: group A (SCD; n = 75) and group B (ECD; n = 46). Group B was composed of older donors (P < .0001), with an increased incidence of diabetes mellitus (DM; P < .0001), arterial hypertension (AH; P < .0001), cerebrovascular accidents (P = .013), and lower creatinine clearances (CrCl; P = .008). Recipient age was significantly lower among group A (P < .0001), with an increased incidence of donor hypotensive episodes (P = .016). The global incidence of DGF was 40 patients (33%), who were mainly in group B (P = .004). Analyzing the entire population, donor age >or= 60 years (P = .005), CrCl < 40 mL/min (P = .025), donor history of DM (P = .026) and AH (P = .017), and cold ischemia time > 15 hours (P < .0001) were parameters related to increased incidences of DGF. A biopsy score of 3 was not significantly associated with DGF. The results of our study underlined the increased risk for DGF related to the use of ECD. Donor age >or= 60 years and cold ischemia time > 15 hours showed strong associations with this complication.
Pretagostini
R
R
Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Umberto I Policlinic of Rome, Rome, Italy.
Lai
Q
Q
Poli
L
L
Levi Sandri
G B
GB
Travaglia
D
D
Rossi
M
M
Berloco
P B
PB
D000328:Adult; D002102:Cadaver; D050377:Cold Ischemia; D051799:Delayed Graft Function / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016030:Kidney Transplantation / Q000401:mortality* / Q000592:standards; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014019:Tissue Donors