Fate of the mate: the influence of delayed graft function in renal transplantation on the mate recipient.
Delayed graft function (DGF) in a deceased-donor renal recipient is associated with allograft dysfunction 1-year posttransplant. There is limited research about the influence to allograft function on the mate of a DGF recipient over time. Using a retrospective cohort design, we studied 55 recipients from a single center. The primary outcome was the change in glomerular filtration rate (GFR) 1-year posttransplant. The secondary outcome was the GFR at baseline. We found that mates to DGF recipients had a mean change in GFR 1-year posttransplant of -11.2 mL/min, while the control group had a mean change of -0.4 mL/min. The difference in the primary outcome was significant (p = 0.025) in a multivariate analysis, adjusting for cold ischemic time, panel reactive antibody level, allograft loss, human leukocyte antibody (HLA)-B mismatches and HLA-DR mismatches. No significant difference between groups was found in baseline GFR. In conclusion, mates to DGF recipients had a significantly larger decline in allograft function 1-year posttransplant compared to controls with similar renal function at baseline. We believe strategies that may preserve allograft function in these'at-risk'recipients should be developed and tested.
Johnson
J F
JF
Department of Medicine, Division of Nephrology, University of Western Ontario, London, Ontario, Canada. john.johnson@lhsc.on.ca
Jevnikar
A M
AM
Mahon
J L
JL
Muirhead
N
N
House
A A
AA
D000328:Adult; D015331:Cohort Studies; D051799:Delayed Graft Function / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006084:Graft Rejection / Q000503:physiopathology; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018454:Spouses; D013997:Time Factors; D014019:Tissue Donors; D014180:Transplantation; D016896:Treatment Outcome