Produção Nacional
Revisado por pares
Exploring the causes of the high incidence of delayed graft function after kidney transplantation in Brazil: a multicenter study
2021; Springer Science+Business Media; Volume: 34; Issue: 6 Linguagem: Inglês
10.1111/tri.13865
ISSN1432-2277
AutoresTainá Veras de Sandes‐Freitas, Marilda Mazzali, Roberto Ceratti Manfro, Luís Gustavo Modelli de Andrade, Alessandra Rosa Vicari, Marcos Vinícius de Sousa, José Osmar Medina Pestana, Valter Duro Garcı́a, Deise Rosa de Boni Monteiro de Carvalho, Ronaldo Esmeraldo, Cláudia Maria Costa de Oliveira, Denise Rodrigues Simão, Luciane Mônica Deboni, Elias David‐Neto, Frederico Castelo Branco Cavalcanti, Álvaro Pacheco‐Silva, Gustavo Fernandes Ferreira, Rafael Lage Madeira, Alexandre Tortoza Bignelli, Geraldo Sérgio Gonçalves Meira, Euler Pace Lasmar, Elizete Keitel, Tereza Azevedo Matuck, Silvana Daher Costa, Hong Si Nga, Paula Frassinetti Castelo Branco Ca Fernandes, Humberto Rebello Narciso, Marcos Alexandre Vieira, Fabiana Agena, Ivailda Barbosa Fonseca, Ana Cristina Carvalho de Matos, Juliana Bastos, S S. Villaça, Sílvia Regina Hokazono, Alberto Rafael Baleeiro Silva, Marcus Faria Lasmar, Hélio Tedesco‐Silva, Carla Elisabete da Silva Oliveira, Cláudia Rosso Felipe, Roger Kist, Cláudia Fagundes, Mariana Moraes Contti, Sônia Leite da Silva, Carlucci Guarberto Ventura, Larissa Guedes da Fonte Andrade, Eduardo José Tonato, Gustavo Rocha de Oliveira, M Puerari, Fernanda Quadros Mendonça Marques, Luís Gustavo Trindade,
Tópico(s)Organ Donation and Transplantation
ResumoThis retrospective multicenter (n = 18) cohort study evaluated the incidence, risk factors, and the impact of delayed graft function (DGF) on 1-year kidney transplant (KT) outcomes. Of 3992 deceased donor KT performed in 2014-2015, the incidence of DGF was 54%, ranging from 29.9% to 87.7% among centers. Risk factors (lower-bound-95%CI OR upper-bound-95%CI ) were male gender (1.066 1.2491.463 ), diabetic kidney disease (1.053 1.2961.595 ), time on dialysis (1.005 1.0071.009 ), retransplantation (1.035 1.3971.885 ), preformed anti-HLA antibodies (1.011 1.3831.892 ), HLA mismatches (1.006 1.0661.130 ), donor age (1.011 1.0171.023 ), donor final serum creatinine (sCr) (1.239 1.3171.399 ), cold ischemia time (CIT) (1.031 1.0431.056 ), machine perfusion (0.401 0.5420.733 ), and induction therapy with rabbit antithymocyte globulin (rATG) (0.658 0.8000.973 ). Duration of DGF > 4 days was associated with inferior renal function and DGF > 14 days with the higher incidences of acute rejection, graft loss, and death. In conclusion, the incidence and duration of DGF were high and associated with inferior graft outcomes. While late referral and poor donor maintenance account for the high overall incidence of DGF, variability in donor and recipient selection, organ preservation method, and type of induction agent may account for the wide variation observed among transplant centers.
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