Perioperative risk factors associated with delayed graft function following deceased donor kidney transplantation:A retrospective,single center study  

作　　者：Nicholas V Mendez Yehuda Raveh Joshua J Livingstone Gaetano Ciancio Giselle Guerra George W Burke III Vadim B Shatz Fouad G Souki Linda J Chen Mahmoud Morsi Jose M Figueiro Tony M Ibrahim Werviston L DeFaria Ramona Nicolau-Raducu 

机构地区：[1]Department of Anesthesiology,University of Miami/Jackson Memorial Hospital,Miami,FL 33136,United States [2]Department of Surgery,Miami Transplant Institute/University of Miami/Jackson Memorial Hospital,Miami,FL 33136,United States [3]Division of Nephrology of the Department of Medicine,University of Miami/Jackson Memorial Hospital,Miami,FL 33136,United States

出　　处：《World Journal of Transplantation》2021年第4期114-128,共15页世界移植杂志

摘　　要：BACKGROUND There is an abundant need to increase the availability of deceased donor kidney transplantation(DDKT)to address the high incidence of kidney failure.Challenges exist in the utilization of higher risk donor organs into what appears to be increasingly complex recipients;thus the identification of modifiable risk factors associated with poor outcomes is paramount.AIM To identify risk factors associated with delayed graft function(DGF).METHODS Consecutive adults undergoing DDKT between January 2016 and July 2017 were identified with a study population of 294 patients.The primary outcome was the occurrence of DGF.RESULTS The incidence of DGF was 27%.Under logistic regression,eight independent risk factors for DGF were identified including recipient body mass index≥30 kg/m^(2),baseline mean arterial pressure<110 mmHg,intraoperative phenylephrine administration,cold storage time≥16 h,donation after cardiac death,donor history of coronary artery disease,donor terminal creatinine≥1.9 mg/dL,and a hypothermic machine perfusion(HMP)pump resistance≥0.23 mmHg/mL/min.CONCLUSION We delineate the association between DGF and recipient characteristics of preinduction mean arterial pressure below 110 mmHg,metabolic syndrome,donorspecific risk factors,HMP pump parameters,and intraoperative use of phenylephrine.

关 键 词：Delayed graft function OUTCOME Kidney transplant Risk factors PHENYLEPHRINE Mean arterial pressure 

分 类 号：R69[医药卫生—泌尿科学]