Medizinische Klinik 4, Nephrologie und Hypertensiologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Medizinische Klinik, Nephrologie und Internistische Intensivmedizin, Charite, Berlin, Germany.
PLoS One. 2018 Jun 21;13(6):e0199445. doi: 10.1371/journal.pone.0199445. eCollection 2018.
The association of delayed graft function (DGF) and biopsy proven acute rejection (BPAR) of renal allografts is controversial. Borderline rejections comprise a major portion of biopsy results but the significance of such histologic changes is debated. The present study explores the impact of DGF on BPAR with a special emphasis on discriminating the effects of borderline rejection.
Single center analysis of 417 deceased donor kidney recipients (age>18; transplantation date 1/2008-2/2015). Patients with primary non-function were excluded. DGF was defined as the need for dialysis within the first week after transplantation. Acute rejection was defined according to Banff criteria. Cox proportional hazards models were used to examine the relationship of DGF with BPAR within the first year.
No graft loss was observed during the first year after transplantation. DGF significantly associated with BPAR in the first year, irrespective of whether borderline rejections were included (HR 1.71, 95%CI 1.16,2.53) or excluded (HR 1.79, 95%CI 1.13,2.84).
DGF is significantly associated with rejection-with or without borderline changes-within the first year.
延迟移植物功能（DGF）与移植肾活检证实的急性排斥反应（BPAR）之间的关联存在争议。边缘性排斥反应构成了活检结果的主要部分，但这种组织学变化的意义仍存在争议。本研究探讨了 DGF 对 BPAR 的影响，特别强调了对边缘性排斥反应的影响进行区分。
对 417 名接受已故供体肾移植的患者（年龄>18 岁；移植日期为 2008 年 1 月至 2015 年 2 月）进行单中心分析。排除了原发性无功能的患者。DGF 定义为在移植后第一周内需要透析。根据 Banff 标准定义急性排斥反应。Cox 比例风险模型用于检查 DGF 与移植后第一年 BPAR 之间的关系。
在移植后第一年没有观察到移植物丢失。DGF 与第一年的 BPAR 显著相关，无论是否包括边缘性排斥反应（HR 1.71，95%CI 1.16，2.53）或排除（HR 1.79，95%CI 1.13，2.84）。
DGF 与排斥反应显著相关，无论是否伴有边缘性变化，均发生在第一年。
