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Delayed graft function is not associated with an increased incidence of renal allograft rejection
- Source :
- Clinical Transplantation. 26:E624-E633
- Publication Year :
- 2012
- Publisher :
- Wiley, 2012.
-
Abstract
- Delayed graft function (DGF) is considered as a risk factor for renal allograft rejection, but this association might be confounded by diagnostic biases (e.g., higher biopsy frequency in patients with DGF, inclusion of clinically diagnosed rejection episodes, and limited details on the rejection phenotype). This retrospective study including 329 deceased donor transplantations aimed to clarify a causal relationship between DGF and rejection. DGF occurred in 93/329 recipients (28%), whereas immediate graft function (IGF) in 236/329 recipients (72%). The percentage of patients with ≥1 allograft biopsy within the first year post-transplant was similar between the DGF and IGF group (96% vs. 94%; p = 0.60). The cumulative one-yr incidence of biopsy-proven clinical (35% vs. 34%; p = 0.62) and combined (sub)clinical rejection (58% vs. 60%; p = 0.79) was not different between the two groups. Furthermore, there were no differences regarding rejection phenotypes/severities and time frame of occurrence. By multivariable Cox regression analysis, donor-specific HLA antibodies, younger recipient age, and immunosuppressive regimens were independent predictors for clinical rejection, while DGF was not. These results in an intermediate sized, but thoroughly investigated patient population challenge the concept that DGF is a risk factor for rejection and highlights the need for additional studies in this regard.
- Subjects :
- Adult
Graft Rejection
Male
medicine.medical_specialty
Delayed Graft Function
Gastroenterology
Postoperative Complications
Risk Factors
Internal medicine
Biopsy
medicine
Humans
Risk factor
Aged
Retrospective Studies
Transplantation
Deceased donor
medicine.diagnostic_test
business.industry
Proportional hazards model
Incidence
Incidence (epidemiology)
Retrospective cohort study
Middle Aged
Prognosis
Kidney Transplantation
Surgery
Survival Rate
Renal allograft
Female
Kidney Diseases
business
Follow-Up Studies
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 09020063
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Clinical Transplantation
- Accession number :
- edsair.doi.dedup.....922ca951994ca605203623092595d852