Delayed graft function is correlated with graft loss in recipients of expanded-criteria rather than standard-criteria donor kidneys:a retrospective,multicenter,observation cohort study  

作　　者：Fei Han Min-Zhuan Lin Hong-Lan Zhou Heng Li Qi-Peng Sun Zheng-Yu Huang Liang-Qing Hong Gang Wang Rui-Ming Cai Qi-Quan Sun 

机构地区：[1]Organ Transplantation Research Institution,Division of Kidney Transplantation,Department of Surgery,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510530,China [2]Department of Renal Transplantation,The Third Affiliated Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510530,China [3]Department of Urology,The First Affiliated Hospital,Jilin University,Changchun,Jilin 130031,China

出　　处：《Chinese Medical Journal》2020年第5期561-570,共10页中华医学杂志（英文版）

基　　金：supported by grants from the National Key R&D Program of China(No.2018YFA0108804);the National Natural Science Foundation of China(No.81770753);the Science and Technology Project of Guangdong Province(No.2015B020226005);the Science and Technology Project of Guangzhou City(No.201604020086).

摘　　要：Background:Although the use of expanded-criteria donors(ECDs)alleviates the problem of organ shortage,it significantly increases the incidence of delayed graft function(DGF).DGF is a common complication after kidney transplantation;however,the effect of DGF on graft loss is uncertain based on the published literature.Hence,the aim of this study was to determine the relationship between DGF and allograft survival.Methods:We conducted a retrospective,multicenter,observation cohort study.A total of 284 deceased donors and 541 recipients between February 2012 and March 2017 were included.We used logistic regression analysis to verify the association between clinical parameters and DGF,and Cox proportional hazards models were applied to quantify the hazard ratios of DGF for kidney graft loss.Results:Among the 284 deceased donors,65(22.8%)donors were ECD.Of the 541 recipients,107(19.8%)recipients developed DGF,and this rate was higher with ECD kidneys than with standard-criteria donor(SCD)kidneys(29.2%vs.17.1%;P=0.003).The 5-year graft survival rate was not significantly different between SCD kidney recipients with and without DGF(95.8%vs.95.4%;P=0.580).However,there was a significant difference between ECD kidney recipients with and without DGF(71.4%vs.97.6%;P=0.001),and the adjusted hazard ratio(HR)for graft loss for recipients with DGF was 1.885(95%confidence interval[CI]=1.305–7.630;P=0.024).Results showed that induction therapy with anti-thymocyte globulin was protective against DGF(odds ratio=0.359;95%CI=0.197–0.652;P=0.001)with all donor kidneys and a protective factor for graft survival(HR=0.308;95%CI=0.130–0.728;P=0.007)with ECD kidneys.Conclusion:DGF is an independent risk factor for graft survival in recipients with ECD kidneys,but not SCD kidneys.

关 键 词：Chronic kidney disease Delayed GRAFT function Expanded-criteria DONORS GRAFT survival Standard-criteria DONORS 

分 类 号：R692[医药卫生—泌尿科学]