title: A pair analysis of the delayed graft function in kidney recipient: the critical role of the donor.
abstract: OBJECTIVE
  The aim of this study was to analyze the importance of donor factors and especially the potential role of hemodynamic management in regard to delayed graft function in paired kidney recipient patients after renal transplantation and to analyze the urine of organ donors by proton-nuclear magnetic resonance spectroscopy to identify urine markers potentially correlated with delayed graft function in recipient patients.
  
  
  METHODS
  A prospective multicenter epidemiologic study was conducted. A logistic regression model taking into account paired data was used.
  
  
  RESULTS
  Data from 72 donors and the 144 corresponding paired recipients were analyzed. Univariate analysis showed that age of donor, previous history of tobacco, ischemic cause of brain death, norepinephrine infusion, and recipient age were the risk factors for delayed graft function. After adjusting for correlated outcome data and controlling for other potential prognostic factors, 3 variables remained significantly associated with outcome: donor age (odds ratio [OR], 10.7), hemodynamic status (OR, 0.167), and hydroxyl-ethyl starch infusion (OR, 0.135). Proton-nuclear magnetic resonance analysis evidenced 3 metabolites of interest in donors (trimethylamine-N-oxide, citrate, and lactate). However, these peaks were not correlated the clinical parameters in donors.
  
  
  CONCLUSIONS
  Paired analysis of kidney transplantation emphasizes the important role of factor donor associated with delayed graft function in recipient. Thus, a particular attention should be paid to the hemodynamic management of donor.
authors.affiliation: INSERM Unité 927 CHU Poitiers, 86021 Poitiers, France. r.robert@chu-poitiers.fr
authors.forename: René
authors.initials: R
authors.lastname: Robert
authors.forename: Joëlle
authors.initials: J
authors.lastname: Guilhot
authors.forename: Michel
authors.initials: M
authors.lastname: Pinsard
authors.forename: Pol-Louis
authors.initials: PL
authors.lastname: Longeard
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Jacob
authors.forename: Valérie
authors.initials: V
authors.lastname: Gissot
authors.forename: Thierry
authors.initials: T
authors.lastname: Hauet
authors.forename: François
authors.initials: F
authors.lastname: Seguin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000652:urine; D001926:Brain Death; D002648:Child; D019343:Citric Acid / Q000652:urine; D051799:Delayed Graft Function / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D019344:Lactic Acid / Q000652:urine; D016015:Logistic Models; D008297:Male; D008744:Methylamines / Q000652:urine; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008744:Methylamines; D019343:Citric Acid; D019344:Lactic Acid; C005855:trimethyloxamine