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Perioperative hemoglobin decrement as an independent risk of poor early graft function in kidney transplantation.

ABSTRACT: OBJECTIVE:Perioperative change of hemoglobin concentration (Hb) was associated with acute kidney injury in patients who underwent non-cardiac surgery, but has never been investigated in kidney transplant patients. This study aimed to observe the effects of perioperative Hb change on early graft function in kidney transplant recipients. RESULTS:A total of 269 kidney transplant patients were enrolled, of whom 98 (36.4%) developed poor early graft function (PEGF), and 171 (63.6%) had immediate graft function. Comparing two groups, patients with PEGF had a greater decremental change of Hb (-1.60 [-2.38,-0.83] vs. -0.70 [-1.35,0.20] g/dL, respectively; p?

SUBMITTER: Chutipongtanate A

PROVIDER: S-EPMC7487588 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Perioperative hemoglobin decrement as an independent risk of poor early graft function in kidney transplantation.

Chutipongtanate Arpa A Kantain Arpakorn A Inksathit Atiporn A Kantachuvesiri Surasak S Sumethkul Vasant V Jirasiritham Siriwan S Jirasiritham Sopon S Chutipongtanate Somchai S

BMC research notes 20200905 1

<h4>Objective</h4>Perioperative change of hemoglobin concentration (Hb) was associated with acute kidney injury in patients who underwent non-cardiac surgery, but has never been investigated in kidney transplant patients. This study aimed to observe the effects of perioperative Hb change on early graft function in kidney transplant recipients.<h4>Results</h4>A total of 269 kidney transplant patients were enrolled, of whom 98 (36.4%) developed poor early graft function (PEGF), and 171 (63.6%) had ...[more]

PMID: 32891182

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Project description:BackgroundThere is controversy regarding the impact of delayed graft function (DGF) on kidney transplant outcomes. We hypothesize that the duration of DGF, rather than DGF itself, is associated with long-term kidney graft function.MethodsWe analyzed all deceased donor kidney transplants (DDKT) done at our center between 2008 to 2020. We determined factors associated with DGF duration. DGF duration was assessed at three 14-day intervals: < 14 DGF days, 14-27 DGF days, > 28 DGF days. We studied the impact of DGF duration on survival and graft function and resource utilization, including hospital length of stay and readmissions.Results1714 DDKT recipients were included, 59.4% (n = 1018) had DGF. The median DGF duration was 10 days IQR (6,15). The majority of recipients (95%) had resolution of DGF within 28 days. Donor factors associated with DGF days were longer cold ischemia time, donor on inotropes, older age, donation after circulatory death, higher terminal creatinine, and hypertension. Recipient factors associated with increased DGF duration included male sex, length on dialysis before transplant, and higher body mass index. There were no differences in acute rejection events or interstitial fibrosis progression by 4 months when comparing DGF days. The median length of stay was 3 days. However, readmissions increased with increasing DGF duration. Death-censored graft survival was not associated with the length of DGF except when DGF lasted > 28 days.ConclusionsInferior graft survival was observed only in recipients of DDKT with DGF lasting beyond 28 days. DGF lasting < 28 days had no impact on graft survival. Duration of DGF, rather than DGF itself, is associated with graft survival.Trial registrationRetrospective study approved by Mayo Clinic IRB number ID: 20-011561.

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