Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
Clinical Research Center for Organ Transplantation in Hunan Province, Changsha, Hunan, 410011, China.
BMC Nephrol. 2020 Dec 4;21(1):526. doi: 10.1186/s12882-020-02181-1.
Delayed graft function (DGF) is closely associated with the use of marginal donated kidneys due to deficits during transplantation and in recipients. We aimed to predict the incidence of DGF and evaluate its effect on graft survival.
This retrospective study on kidney transplantation was conducted from January 1, 2018, to December 31, 2019, at the Second Xiangya Hospital of Central South University. We classified recipients whose operations were performed in different years into training and validation cohorts and used data from the training cohort to analyze predictors of DGF. A nomogram was then constructed to predict the likelihood of DGF based on these predictors.
The incidence rate of DGF was 16.92%. Binary logistic regression analysis showed correlations between the incidence of DGF and cold ischemic time (CIT), warm ischemic time (WIT), terminal serum creatine (Scr) concentration, duration of pretransplant dialysis, primary cause of donor death, and usage of LifePort. The internal accuracy of the nomogram was 83.12%. One-year graft survival rates were 93.59 and 99.74%, respectively, for the groups with and without DGF (P < 0.05).
The nomogram established in this study showed good accuracy in predicting DGF after deceased donor kidney transplantation; additionally, DGF decreased one-year graft survival.
由于移植过程中以及受者的缺陷，延迟移植物功能（DGF）与使用边缘供体肾脏密切相关。我们旨在预测 DGF 的发生率，并评估其对移植物存活率的影响。
本回顾性研究于 2018 年 1 月 1 日至 2019 年 12 月 31 日在中南大学湘雅二医院进行，将手术年份不同的受者分为训练和验证队列，并使用训练队列中的数据分析 DGF 的预测因素。然后根据这些预测因素构建一个列线图来预测 DGF 的可能性。
DGF 的发生率为 16.92%。二元逻辑回归分析显示，DGF 的发生率与冷缺血时间（CIT）、热缺血时间（WIT）、终末血清肌酐（Scr）浓度、移植前透析时间、供体死亡的主要原因和使用 LifePort 之间存在相关性。列线图的内部准确性为 83.12%。DGF 组和无 DGF 组的 1 年移植物存活率分别为 93.59%和 99.74%（P<0.05）。
本研究建立的列线图在预测死亡供体肾移植后 DGF 方面具有良好的准确性；此外，DGF 降低了 1 年移植物存活率。
