Analysis of Pre-Transplant Resuscitation Factors Influencing Immediate Graft Function after Deceased Donor Kidney Transplantation
General Surgery, Seoul St. Mary's Hospital, Seoul, Korea, Republic of
Meeting: 2020 American Transplant Congress
Abstract number: A-231
Keywords: Donors, unrelated, Graft function, Kidney transplantation, Risk factors
Session Information
Session Name: Poster Session A: Deceased Donor Management and Intervention Research
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: The management of a deceased donor in the intensive care unit before organ transplantation is important for the outcome of the recipient. Herein, we analyze the pre-transplant resuscitation factors managed before procurement that could influence graft function immediately after deceased-donor kidney transplantation (DDKT).
*Methods: A total of 271 DDKTs performed at Seoul St. Mary’s Hospital, Korea, from January 2009 to March 2016 were reviewed. We divided the patients into a delayed graft function (DGF) group and a non-DGF group, and compared postoperative outcomes between the 2 groups. We also analyzed the predisposing factors of DGF using multivariate analysis.
*Results: A total of 36 cases developed DGF while 235 patients did not, and the demographic characteristics of the recipients in the two groups had no significant difference. Of the pre-transplant resuscitation factors, preoperative polyuria, the maximal levels of serum sodium and BUN, and transfer times were significantly higher in the DGF group (P < .001). In a multivariable analysis, preoperative polyuria (odds ratio 4.835, P = .036), elevated preoperative level of sodium (odds ratio 1.227, P = .001), and extended transfer times (odds ratio 1.001, P < .001) were the independent risk factors of the donor in pre-transplant resuscitation management associated with DGF.
*Conclusions: Polyuria, high levels of sodium before procurement, and prolonged transfer times are independent risk factors for DGF after a DDKT. Active intervention and early implementation of the intensivist can help in managing these factors effectively and thus ultimately improve graft function.
| Characteristics | Total (n=271) | DGF (n=36) | Non-DGF (n=235) | p-value |
| Preoperative polyuria | 222 (81.9) | 20 (55.6) | 202 (86) | < 0.001 |
| Transfer time (min) | 2424.8±1606.8 (100-21600) | 4754.1±4267.7 (111-21600) | 1124.6±1517.5 (100-7500) | < 0.001 |
| BUN(maximum) | 31.7±17.3 (6.8-102) | 45.4±20.3 (13.0-95) | 29.6±15.8 (6.8-102) | < 0.001 |
| BUN(final) | 25.2±14.3 (3-70.3) | 43±20 (5.5-70.3) | 22.4±10.9 (3-59.4) | < 0.001 |
| Creatinine(maximum) | 2.36±1.73 (0.3-9.8) | 3.73±1.81 (0.3-7.9) | 2.15±1.63 (0.3-9.8) | < 0.001 |
| Creatinine(final) | 2.18±1.65 (0.21-9.8) | 3.63±1.76 (0.33-7.93) | 1.96±1.52 (0.21-9.8) | < 0.001 |
| Maximum level of sodium | 161.7±11.3 (133-201) | 157.2±11.7 (134.0-179) | 162.4±11.1 (133-201) | 0.010 |
| Variable | Odds Ratio | 95% CI | p-value |
| Elevated preoperative Creatininemax | 1.306 | 0.261 – 6.541 | 0.746 |
| Elevated preoperative Namax | 0.952 | 0.903 – 1.005 | 0.074 |
| Elevated preoperative BUNmax | 0.909 | 0.817 – 1.011 | 0.078 |
| Elevated preoperative Creatininefinal | 0.826 | 0.175 – 3.888 | 0.809 |
| Preoperative polyuria | 4.835 | 1.109 – 21.084 | 0.036* |
| Elevated preoperative BUNfinal | 1.227 | 1.082 – 1.392 | 0.001* |
| Prolonged transfer time | 1.001 | 1.000 – 1.002 | <0.001* |
To cite this abstract in AMA style:
Park S. Analysis of Pre-Transplant Resuscitation Factors Influencing Immediate Graft Function after Deceased Donor Kidney Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/analysis-of-pre-transplant-resuscitation-factors-influencing-immediate-graft-function-after-deceased-donor-kidney-transplantation/. Accessed November 24, 2024.« Back to 2020 American Transplant Congress