Prolonged cold ischemia: risk factor for acute rejection in renal grafting of cadaveric kidney transplantation.
BACKGROUND
Exposure of renal grafting to prolonged cold ischemia time (CIT) and the association with acute rejection (AR) are known. However, there is no evidence in Mexico about this topic. Thus, the objective of this study was to evaluate prolonged CIT as a risk factor for AR in renal grafting of cadaveric kidney transplantation in a Mexican population.


METHODS
A cross-sectional study was carried out. Clinical files of patients undergoing renal grafting using cadaveric kidneys were reviewed from July 1994-June 2004. Prolonged CIT (=12 h) as a risk factor for AR was evaluated. Other related variables were also examined.


RESULTS
From 425 kidney transplantations, only 33 cases were cadaveric. Ten patients had AR. Prolonged CIT (OR 8.4; CI 1.5-44.2, p = 0.02) and azathioprine (AZA)-prednisone (PDN)-cyclosporine (CSA) combination (OR 9.1; CI 1.5-49.4, p = 0.02) were risk factors for AR. Anti-CD25 use (OR 0.6; CI 0.009-0.37, p = 0.001) and mycofenolate mofetil (MMF)-PDN-CSA combination (OR 0.1; CI 0.02-0.65, p = 0.02) were protective factors for AR.


CONCLUSIONS
In a Mexican population, prolonged CIT and AZA-PDN-CSA combination were risk factors for AR. Meanwhile, anti- CD25 use and MMF-PDN-CSA combination were protective factors for AR in cadaveric kidney transplantations.
Ruiz-George
Oscar Manuel
OM
Hospital Regional Universitario, Secretaria de Salud, Colima, México.
Trujillo-Hernández
Benjamín
B
Millán-Guerrero
Rebeca Olivia
RO
Vásquez-Jiménez
Clemente
C
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002102:Cadaver; D050377:Cold Ischemia / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D051799:Delayed Graft Function; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007668:Kidney / Q000098:blood supply*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D020858:Tissue and Organ Harvesting / Q000379:methods*; D055815:Young Adult
D007166:Immunosuppressive Agents