title: A useful scoring system for the prediction and management of delayed graft function following kidney transplantation from cadaveric donors.
abstract: Delayed graft function (DGF) is a common complication in kidney transplantation and is known to be correlated with short- and long-term graft outcomes. Here we explored the possibility of developing a simple tool that could predict with good confidence the occurrence of DGF and could be helpful in current clinical practice. We built a score, tentatively called DGFS, from a French multicenter and prospective cohort of 1844 adult recipients of deceased donor kidneys collected since 2007, and computerized in the Données Informatisées et VAlidées en Transplantation databank. Only five explicative variables (cold ischemia time, donor age, donor serum creatinine, recipient body mass index, and induction therapy) contributed significantly to the DGF prediction. These were associated with a good predictive capacity (area under the ROC curve at 0.73). The DGFS calculation is facilitated by an application available on smartphones, tablets, or computers at www.divat.fr/en/online-calculators/dgfs. The DGFS should allow the simple classification of patients according to their DGF risk at the time of transplantation, and thus allow tailored-specific management or therapeutic strategies.
authors.affiliation: 1] Institut de Transplantation et de Recherche en Transplantation, ITUN, CHU Nantes, RTRS « Centaure », Nantes and Inserm U1064 (Immunointervention dans les Allo et Xénotransplantation), Nantes University, boulevard Jean Monnet, Nantes, France [2] Centre d'Investigation Clinique biothérapie, Labex Transplantex, boulevard Jean Monnet, Nantes, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Chapal
authors.affiliation: EA 4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology, Nantes University, Nantes, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Le Borgne
authors.affiliation: 1] Service de Transplantation Rénale et de Soins Intensifs, Hôpital Necker, APHP, Paris, France [2] Universités Paris Descartes et Sorbonne Paris Cité, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Legendre
authors.affiliation: 1] Service de Transplantation Rénale et de Soins Intensifs, Hôpital Necker, APHP, Paris, France [2] Universités Paris Descartes et Sorbonne Paris Cité, Paris, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Kreis
authors.affiliation: Service de Néphrologie, Dialyse et Transplantation, Hôpital Lapeyronie, Montpellier, Université Montpellier I, Montpellier, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Mourad
authors.affiliation: Service de Néphrologie, Dialyse et Transplantation, Hôpital Lapeyronie, Montpellier, Université Montpellier I, Montpellier, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Garrigue
authors.affiliation: Service de Néphrologie, Transplantation et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Morelon
authors.affiliation: Service de Néphrologie, Transplantation et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Buron
authors.affiliation: 1] Service de Néphrologie, HTA, Dialyse et Transplantation d'Organes, CHU Rangueil, Toulouse, France [2] Université Paul Sabatier, Toulouse, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
authors.affiliation: 1] Service de Néphrologie, HTA, Dialyse et Transplantation d'Organes, CHU Rangueil, Toulouse, France [2] Université Paul Sabatier, Toulouse, France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.affiliation: Service de Transplantation Rénale, CHU Brabois, Nancy, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Kessler
authors.affiliation: Service de Transplantation Rénale, CHU Brabois, Nancy, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Ladrière
authors.affiliation: 1] Institut de Transplantation et de Recherche en Transplantation, ITUN, CHU Nantes, RTRS « Centaure », Nantes and Inserm U1064 (Immunointervention dans les Allo et Xénotransplantation), Nantes University, boulevard Jean Monnet, Nantes, France [2] Centre d'Investigation Clinique biothérapie, Labex Transplantex, boulevard Jean Monnet, Nantes, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Soulillou
authors.affiliation: 1] Institut de Transplantation et de Recherche en Transplantation, ITUN, CHU Nantes, RTRS « Centaure », Nantes and Inserm U1064 (Immunointervention dans les Allo et Xénotransplantation), Nantes University, boulevard Jean Monnet, Nantes, France [2] EA 4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology, Nantes University, Nantes, France.
authors.forename: Katy
authors.initials: K
authors.lastname: Launay
authors.affiliation: Institut de Transplantation et de Recherche en Transplantation, ITUN, CHU Nantes, RTRS « Centaure », Nantes and Inserm U1064 (Immunointervention dans les Allo et Xénotransplantation), Nantes University, boulevard Jean Monnet, Nantes, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Daguin
authors.affiliation: EA 4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology, Nantes University, Nantes, France.
authors.forename: Lucile
authors.initials: L
authors.lastname: Offredo
authors.affiliation: 1] Institut de Transplantation et de Recherche en Transplantation, ITUN, CHU Nantes, RTRS « Centaure », Nantes and Inserm U1064 (Immunointervention dans les Allo et Xénotransplantation), Nantes University, boulevard Jean Monnet, Nantes, France [2] Centre d'Investigation Clinique biothérapie, Labex Transplantex, boulevard Jean Monnet, Nantes, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Giral
authors.affiliation: 1] Institut de Transplantation et de Recherche en Transplantation, ITUN, CHU Nantes, RTRS « Centaure », Nantes and Inserm U1064 (Immunointervention dans les Allo et Xénotransplantation), Nantes University, boulevard Jean Monnet, Nantes, France [2] EA 4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology, Nantes University, Nantes, France.
authors.forename: Yohann
authors.initials: Y
authors.lastname: Foucher
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D019540:Area Under Curve; D015992:Body Mass Index; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D050377:Cold Ischemia / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D003661:Decision Support Techniques; D051799:Delayed Graft Function / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D060828:Induction Chemotherapy; D007223:Infant; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D000068997:Smartphone; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D003404:Creatinine