title: [Vasculopathy in the kidney allograft at time of transplantation delays recovery of graft function after deceased-donor kidney transplantation].
abstract: OBJECTIVE
  The purpose of this study was to evaluate the impact of donor and recipient characteristics on duration of delayed graft function (DGF) and 1-year serum creatinine (SCr), as a surrogate endpoint for allograft survival.
  
  
  METHODS
  We reviewed 120 first cadaver kidney transplants carried out consecutively at our center to examine the effect on 1-year SCr of the presence and duration of DGF.
  
  
  RESULTS
  DGF rate was 68%, with a median duration of 12 days (range, 1-61). Forty-four (38%) patients presented DGF lasting 12 or more days (prolonged DGF group). Mean donor age was 43 ± 13 years, 37% had hypertension and in 59% the cause of brain death was cardiovascular accident. The mean cold ischemia time was 23 ± 5 hours. Twenty-seven (23%) donors were classified as expanded-criteria donors according to OPTN criteria. The mean recipient age was 51 ± 15 years. The recipients median time in dialysis was 43 months (range, 1-269) and 25% of them had panel reactive antibodies > 0%. Patients with prolonged DGF presented higher 1-year SCr in comparison with patients without DGF (1.7 vs. 1.3 mg/dL, respectively, p = 0.03). In multivariate logistic regression analysis, the only significant factor contributing to the occurrence of prolonged DGF was the presence of vascular lesions in the kidney allograft at time of transplantation (HR 3.6, 95% CI 1.2-10.2; p = 0.02).
  
  
  CONCLUSIONS
  The presence of vasculopathy in the kidney allograft at time of transplantation was identified as an important factor independently associated with prolonged DGF. Prolonged DGF negatively impacts 1-year graft function.
authors.affiliation: Faculdade de Medicina, Universidade de Sao Paulo.
authors.forename: Igor Denizarde Bacelar
authors.initials: ID
authors.lastname: Marques
authors.affiliation: Faculdade de Medicina, Universidade de Sao Paulo.
authors.forename: Liliany Pinhel
authors.initials: LP
authors.lastname: Repizo
authors.affiliation: Faculdade de Medicina, Universidade de Sao Paulo.
authors.forename: Renato
authors.initials: R
authors.lastname: Pontelli
authors.affiliation: Faculdade de Medicina, Universidade de Sao Paulo.
authors.forename: Flavio Jota
authors.initials: FJ
authors.lastname: de Paula
authors.affiliation: Faculdade de Medicina, Universidade de Sao Paulo.
authors.forename: William Carlos
authors.initials: WC
authors.lastname: Nahas
authors.affiliation: Faculdade de Medicina, Universidade de Sao Paulo.
authors.forename: Daísa Silva Ribeiro
authors.initials: DS
authors.lastname: David
authors.affiliation: Faculdade de Medicina, Universidade de Sao Paulo.
authors.forename: Elias David
authors.initials: ED
authors.lastname: Neto
authors.affiliation: Faculdade de Medicina, Universidade de Sao Paulo.
authors.forename: Francine Brambate Carvalhinho
authors.initials: FB
authors.lastname: Lemos
mesh_terms: D000328:Adult; D064591:Allografts; D002102:Cadaver; D051799:Delayed Graft Function / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000150:complications* / Q000601:surgery*; D016030:Kidney Transplantation; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications*