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与移植肾功能延迟相关的因素及其对肾移植结局的影响。

Factors Associated With Delayed Graft Function and Their Influence on Outcomes of Kidney Transplantation.

作者信息

Salazar Meira F, Zemiacki J, Figueiredo A E, Viliano Kroth L, Saute Kochhann D, d'Avila D O, Traesel M, Saitovitch D, Poli-de-Figueiredo C E

机构信息

Programa de Pós-graduação em Medicina e Ciências da Saúde da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Nephrology: FAMED, FAENFI, IPB, HSL, Porto Alegre, Brazil.

Programa de Pós-graduação em Medicina e Ciências da Saúde da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Nephrology: FAMED, FAENFI, IPB, HSL, Porto Alegre, Brazil; Faculdade de Ciências Econômicas. Master in Economia Aplicada. Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.

出版信息

Transplant Proc. 2016 Sep;48(7):2267-2271. doi: 10.1016/j.transproceed.2016.06.007.

Abstract

BACKGROUND

One of the main postoperative complications of kidney transplant is delayed graft function (DGF), which means absence of graft function after transplant or the need for dialysis during the first week post procedure. The occurrence of DGF currently in our hospital is high and has been attributed to a combination of many factors. The aim of this study was to evaluate the factors associated to DGF and their influence in the outcome of kidney transplants.

METHODS

Historical cohort of 150 patients transplanted with live or deceased donor kidneys from 2011 to 2013.

RESULTS

DGF was associated to time in dialysis and the number of recipient pre-transplant transfusions, donors age, serum creatinine level, use of vasoactive drugs in the donor, distance from place of organ retrieval and transplant center, and duration of cold ischemia time. DGF influenced post-transplantation outcome in regard to length of stay in intensive care, length of hospital stay, acute rejection episodes, and higher creatinine levels at discharge. Patients and graft survival were shorter in the DGF group.

CONCLUSIONS

There are multiple factors related to DGF, the most important being those related to donors, and organ storage. The most important factor related to the recipient was the dialysis vintage. We did not find a correlation between DGF and HLA-compatibility. DGF consequences are important, including worse graft function and survival, as well as impact in recipient morbidity and mortality.

摘要

背景

肾移植术后的主要并发症之一是移植肾功能延迟恢复(DGF),即移植后无移植肾功能或术后第一周内需进行透析。目前我院DGF的发生率较高,且归因于多种因素的综合作用。本研究的目的是评估与DGF相关的因素及其对肾移植结局的影响。

方法

对2011年至2013年接受活体或尸体供肾移植的150例患者进行回顾性队列研究。

结果

DGF与透析时间、受者移植前输血次数、供者年龄、血清肌酐水平、供者使用血管活性药物、器官获取地与移植中心的距离以及冷缺血时间的长短有关。DGF在重症监护病房住院时间、住院时间、急性排斥反应发作以及出院时较高的肌酐水平方面影响移植后结局。DGF组患者和移植物的存活时间较短。

结论

与DGF相关的因素有多个,其中最重要的是与供者及器官保存相关的因素。与受者相关的最重要因素是透析龄。我们未发现DGF与HLA相容性之间存在相关性。DGF的后果很严重,包括移植肾功能和存活率较差,以及对受者发病率和死亡率的影响。

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