1. A prediction model of delayed graft function in deceased donor for renal transplant: a multi-center study from China
- Author
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Wujun Xue, Jianming Tan, Yaowen Fu, Xiaotong Wu, Qifa Ye, Lixin Yu, Li Zeng, Jianghua Chen, Zheng Chen, Yongheng Zhao, Tongyi Men, Guiwen Feng, Tao Lin, Bingyi Shi, Changxi Wang, Xiaodong Zhang, Jiangqiao Zhou, Yingxin Fu, Yingzi Ming, Zhishui Chen, Zhen Dong, Qiquan Sun, Weiguo Sui, Tongyu Zhu, Chibing Huang, Ming Zhao, Qingshan Qu, Longkai Peng, and Xuyong Sun
- Subjects
Adult ,Male ,Brain Death ,China ,medicine.medical_specialty ,030232 urology & nephrology ,Transplants ,030204 cardiovascular system & hematology ,Kidney ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,delayed graft function ,0302 clinical medicine ,Renal Dialysis ,Humans ,Transplantation, Homologous ,risk factors ,Medicine ,Retrospective Studies ,Deceased donor ,business.industry ,Incidence ,Incidence (epidemiology) ,Cold Ischemia ,Graft Survival ,General Medicine ,Middle Aged ,renal transplantation ,Kidney Transplantation ,Tissue Donors ,Diseases of the genitourinary system. Urology ,Delayed Graft Function ,Surgery ,Transplantation ,surgical procedures, operative ,ROC Curve ,Nephrology ,Renal transplant ,Creatinine ,Multi center study ,Clinical Study ,deceased donor ,Female ,RC870-923 ,business ,Research Article - Abstract
Background Kidneys obtained from deceased donors increase the incidence of delayed graft function (DGF) after renal transplantation. Here we investigated the influence of the risk factors of donors with DGF, and developed a donor risk scoring system for DGF prediction. Methods This retrospective study was conducted in 1807 deceased kidney donors and 3599 recipients who received donor kidneys via transplants in 29 centers in China. We quantified DGF associations with donor clinical characteristics. A donor risk scoring system was developed and validated using an independent sample set. Results The incidence of DGF from donors was 19.0%. Six of the donor characteristics analyzed, i.e., age, cause of death, history of hypertension, terminal serum creatinine, persistence of hypotension, and cardiopulmonary resuscitation (CPR) time were risk factors for DGF. A 49-point scoring system of donor risk was established for DGF prediction and exhibited a superior degree of discrimination. External validation of DGF prediction revealed area under the receiver-operating characteristic (AUC) curves of 0.7552. Conclusions Our study determined the deceased donor risk factors related to DGF after renal transplantation pertinent to the Chinese cohort. The scoring system developed here had superior diagnostic significance and consistency and can be used by clinicians to make evidence-based decisions on the quality of kidneys from deceased donors and guide renal transplantation therapy.
- Published
- 2021