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At least 199 records · Page 11Linked to original sources
PubMed1994

Effect of prolonged delayed graft function on long-term graft outcome in cadaveric kidney transplantation.

One-hundred-and-twenty-six cadaveric renal transplantations were analyzed for the effect of post-transplant renal function on graft outcome. Thirty-one grafts functioned immediately after transplantation (Group 1), 54 grafts failed to function temporarily up to 8 posttransplant days as evidenced by urine output < 400 ml/day or hemodialysis support (Group 2), 33 grafts showed temporary nonfunction > 8 days (Group 3) and 8 grafts never functioned (group 4). Five-year graft failure rates were 6.5% (2/31), 13.0% (7/54), 42.4% (14/33) and 100% (8/8) for Groups 1, 2, 3 and 4, respectively. Actuarial 5-year graft survivals were 89.4%, 84.8%, 50% and 0% for Groups 1, 2, 3 and 4, respectively (p < 0.05). The most common cause of graft failure was the chronic rejection in 13, of which 9 were in Group 3. Acute rejection episodes during the first 3 months post-transplant in Group 3 (15 of 33, 45.5%) was slightly higher than that in Group 1 (10 of 30, 33.3%) or Group 2 (19 of 54, 35.2%) but the differences were not significant. Acute rejection episodes were associated with graft loss only 1 of 19 (5.3%) patients in Group 2 whereas 9 of 15 (47.4%) were seen in Group 3. The authors conclude that prolonged DGF is associated with a higher incidence of graft failure, particularly secondary to chronic rejection after 1 year posttransplant. Moreover, acute rejection based on prolonged DGF probably plays a major role in the development of chronic rejection.

Adolescent↗
PubMed1992

A preliminary report of the HTK randomized multicenter study comparing kidney graft preservation with HTK and EuroCollins solutions. HTK Study Group.

The main goal of transplantation is to restore good renal function and to improve the quality of life of thousands of dialysis patients, something which can only be achieved by providing them with well functioning grafts. Delayed renal allograft function is a serious problem. It is important to prevent this complication because it makes the diagnosis of acute rejection in the early postoperative period difficult, increases the necessity for diagnostic procedures, introduces dialysis treatments and prolongs hospital stay. The aetiology of delayed graft function (DGF) is multifactorial, and factors including donor management, technique used for organ procurement and preservation, age, anatomical variations in the graft, ischemia periods, use of cyclosporine A (CyA) or recipient immunological reactions have been implicated. Using different preservation solutions DGF rates vary from 30% to 60%. Recent clinical data have demonstrated better preservation and improved renal function posttransplant with HTK and University of Wisconsin (UW) solutions compared to EuroCollins solution. In a randomized multicenter study in collaboration with the Eurotransplant organ exchange organization, the efficacy of the HTK solution in renal transplantation was compared to EuroCollins and UW solutions in two parallel prospective randomized trials. The first preliminary results comparing HTK and EuroCollins solutions are reported here.

Creatinine↗