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一种用于预测和管理尸体供肾移植后延迟肾功能的有用评分系统。

A useful scoring system for the prediction and management of delayed graft function following kidney transplantation from cadaveric donors.

机构信息

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.

EA 4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology, Nantes University, Nantes, France.

出版信息

Kidney Int. 2014 Dec;86(6):1130-9. doi: 10.1038/ki.2014.188. Epub 2014 Jun 4.

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.

摘要

延迟性移植物功能障碍(DGF)是肾移植中的一种常见并发症,已知与短期和长期移植物结局相关。在这里,我们探讨了开发一种简单工具的可能性,该工具可以很好地预测 DGF 的发生,并可能有助于当前的临床实践。我们从 2007 年以来在法国多中心前瞻性队列中收集的 1844 例接受已故供体肾脏的成年受者的数据中建立了一个评分,暂定名为 DGFS,并在 Données Informatisées et VAlidées en Transplantation 数据库中进行了计算机化处理。只有五个解释性变量(冷缺血时间、供者年龄、供者血清肌酐、受者体重指数和诱导治疗)对 DGF 预测有显著贡献。这些变量与良好的预测能力(ROC 曲线下面积为 0.73)相关。DGFS 的计算可通过智能手机、平板电脑或计算机上的应用程序(www.divat.fr/en/online-calculators/dgfs)轻松实现。DGFS 可根据移植时患者的 DGF 风险进行简单的分类,从而允许制定特定的管理或治疗策略。

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