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Factors predicting kidney delayed graft function among recipients of simultaneous liver-kidney transplantation: A single-center experience.
Korayem, Islam M; Agopian, Vatche G; Lunsford, Keri E; Gritsch, Hans A; Veale, Jeffrey L; Lipshutz, Gerald S; Yersiz, Hasan; Serrone, Coney L; Kaldas, Fady M; Farmer, Douglas G; Bunnapradist, Suphamai; Danovitch, Gabriel M; Busuttil, Ronald W; Zarrinpar, Ali.
Afiliação
  • Korayem IM; Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
  • Agopian VG; Department of Surgery, Hepato-Pancreato-Biliary and Liver Transplantation Surgery Unit, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
  • Lunsford KE; Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
  • Gritsch HA; Sherrie and Alan Conover Center for Liver Disease and Transplantation, J.C. Walter Jr Transplant Center, Weill Cornell Medical College, Houston Methodist Hospital, Houston, Texas.
  • Veale JL; Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California.
  • Lipshutz GS; Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California.
  • Yersiz H; Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
  • Serrone CL; Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California.
  • Kaldas FM; Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
  • Farmer DG; Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
  • Bunnapradist S; Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
  • Danovitch GM; Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
  • Busuttil RW; Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, California.
  • Zarrinpar A; Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, California.
Clin Transplant ; 33(6): e13569, 2019 06.
Article em En | MEDLINE | ID: mdl-31006141
ABSTRACT

BACKGROUND:

Kidney delayed graft function (kDGF) remains a challenging problem following simultaneous liver and kidney transplantation (SLKT) with a reported incidence up to 40%. Given the scarcity of renal allografts, it is crucial to minimize the development of kDGF among SLKT recipients to improve patient and graft outcomes. We sought to assess the role of preoperative recipient and donor/graft factors on developing kDGF among recipients of SLKT.

METHODS:

A retrospective review of 194 patients who received SLKT in the period from January 2004 to March 2017 in a single center was performed to assess the effect of preoperative factors on the development of kDGF.

RESULTS:

Kidney delayed graft function was observed in 95 patients (49%). Multivariate analysis revealed that donor history of hypertension, cold static preservation of kidney grafts [versus using hypothermic pulsatile machine perfusion (HPMP)], donor final creatinine, physiologic MELD, and duration of delay of kidney transplantation after liver transplantation were significant independent predictors for kDGF. kDGF is associated with worse graft function and patient and graft survival.

CONCLUSIONS:

Kidney delayed graft function has detrimental effects on graft function and graft survival. Understanding the risks and combining careful perioperative patient management, proper recipient selection and donor matching, and graft preservation using HPMP would decrease kDGF among SLKT recipients.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Preservação de Órgãos / Transplante de Rim / Transplante de Fígado / Temperatura Baixa / Medição de Risco / Função Retardada do Enxerto / Sobrevivência de Enxerto Idioma: En Ano de publicação: 2019 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Preservação de Órgãos / Transplante de Rim / Transplante de Fígado / Temperatura Baixa / Medição de Risco / Função Retardada do Enxerto / Sobrevivência de Enxerto Idioma: En Ano de publicação: 2019 Tipo de documento: Article