title: Effects of different trends on the development and outcome of early kidney allograft dysfunction.
abstract: OBJECTIVE
  To show the effects of different factors on development and outcome of early kidney allograft dysfunction.
  
  
  METHODS
  Two hundred thirty-one kidney transplant recipients were divided into 2 groups: group 1 (125 patients transplanted from 1999-2004) and group 2 (106 patients transplanted from 2008-2013). Age range was 12 to 62 years (group 1) and 7 to 71 years (group 2). Deceaseddonor transplant was more frequent in group 1 (76.8%), and living-donor transplant in group 2 (68.8%). In group 1, transplant was performed for glomerulonephritis or pyelonephritis; in group 2, additional risk factors (18 patients) included diabetes (11 patients), systemic lupus erythematosus (5 patients), amyloidosis (1 patient), and aortic and mitral valve replacement because of bacterial endocarditis (1 patient). In groups 1 and 2, immunosuppression after transplant included cyclosporine, mycophenolate mofetil, and steroids; patients in group 2 also had induction with anti-CD25 monoclonal antibodies.
  
  
  RESULTS
  Primary graft function occurred in 89 patients in group 1 (71.2%) and 83 patients in group 2 (78.3%). Immediately after transplant, delayed graft function included anuria, oliguria, adequate amount of urine, and secondary delayed function (several days of polyuria followed by decreased urine output). Ischemia was a leading cause of delayed renal graft function. Anuria after living-donor transplant was a sign of vascular thrombosis. Rejection was the main cause of secondary delayed graft function, which occurred in only group 1. Survival at 1 year in patients with delayed graft function was 80% in group 1 and 100% in group 2 because of the absence of septic complications.
  
  
  CONCLUSIONS
  Despite extension of indications, primary functioning of kidney transplants and patient survival increased. Improved care enables long-term rehabilitation of recipients and expanding criteria for kidney transplant.
authors.affiliation: From the Transplant Center, Regional Clinical Hospital, Donetsk, Ukraine.
authors.forename: Viktor K
authors.initials: VK
authors.lastname: Denisov
authors.forename: Vadim V
authors.initials: VV
authors.lastname: Zakharov
authors.forename: Eugeny V
authors.initials: EV
authors.lastname: Onishchenko
authors.forename: Tatyana S
authors.initials: TS
authors.lastname: Golubova
authors.forename: Yana G
authors.initials: YG
authors.lastname: Mitsuk
authors.forename: Olga V
authors.initials: OV
authors.lastname: Zakharova
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D002648:Child; D051799:Delayed Graft Function / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D008297:Male; D008875:Middle Aged; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents