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Analysis of Pre-Transplant Resuscitation Factors Influencing Immediate Graft Function after Deceased Donor Kidney Transplantation

S. Park

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.

Demographic characteristics and pre-transplant resuscitation factors of donors
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
Risk factors of pre-transplant resuscitation factors associated with delayed graft function
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*

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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 June 6, 2025.

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