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- Title
Prediction of kidney transplant outcome based on different DGF definitions in Chinese deceased donation.
- Authors
Hu, Xiao-jun; Zheng, Jin; Li, Yang; Tian, Xiao-hui; Tian, Pu-xun; Xiang, He-li; Pan, Xiao-ming; Ding, Chen-guang; Ding, Xiao-ming; Xue, Wu-jun
- Abstract
<bold>Background: </bold>Delayed graft function (DGF) is an important complication of kidney transplantation and can be diagnosed according to different definitions. DGF has been suggested to be associated with the long-term outcome of kidney transplantation surgery. However, the best DGF definition for predicting renal transplant outcomes in Chinese donations after cardiac death (DCDs) remains to be determined.<bold>Method: </bold>A total of 372 DCD kidney transplant recipients from June 2013 to July 2017 in the First Affiliated Hospital of Xi'an Jiaotong University were included in this retrospective study to compare 6 different DGF definitions. The relationships of the DGF definitions with transplant outcome were analyzed, including graft loss (GL) and death-censored graft loss (death-censored GL). Renal function indicators, including one-year estimated glomerular filtration rate (eGFR) and three-year eGFR, and were compared between different DGF groups.<bold>Results: </bold>The incidence of DGF varied from 4.19 to 35.22% according to the different DGF diagnoses. All DGF definitions were significantly associated with three-year GL as well as death-censored GL. DGF based on requirement of hemodialysis within the first week had the best predictive value for GL (AUC 0.77), and DGF based on sCr variation during the first 3 days post-transplant had the best predictive value for three-year death-censored GL (AUC 0.79). Combination of the 48-h sCr reduction ratio and classical DGF can improve the AUC for GL (AUC 0.85) as well as the predictive accuracy for death-censored GL (83.3%).<bold>Conclusion: </bold>DGF was an independent risk factor for poor transplant outcome. The combination of need for hemodialysis within the first week and the 48-h serum creatinine reduction rate has a better predictive value for patient and poor graft outcome.
- Publication
BMC Nephrology, 2019, Vol 20, Issue 1, p1
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-019-1557-x