title: Predictive characteristics of delayed graft function after expanded and standard criteria donor kidney transplantations.
abstract: 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.
authors.affiliation: Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Umberto I Policlinic of Rome, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pretagostini
authors.forename: Q
authors.initials: Q
authors.lastname: Lai
authors.forename: L
authors.initials: L
authors.lastname: Poli
authors.forename: G B
authors.initials: GB
authors.lastname: Levi Sandri
authors.forename: D
authors.initials: D
authors.lastname: Travaglia
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: P B
authors.initials: PB
authors.lastname: Berloco
mesh_terms: 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