Increased Intra-Abdominal Pressure is Associated with Delayed Graft Function after Kidney Transplantation
1Nephrology, Hospital Clínico Universitario, Valladolid, Spain, 2Nephrology, Hospital Del Mar, Barcelona, Spain, 3Cardiac Surgery, Hospital Clínico Universitario, Valladolid, Spain
Meeting: 2020 American Transplant Congress
Abstract number: D-081
Keywords: Graft function, Kidney, Post-operative complications, Surgical complications
Session Information
Session Name: Poster Session D: Kidney Technical
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Increased intra-abdominal pressure (IAP) is a common complication among critically ill and post-surgical patients that can cause organ dysfunction. Its prevalence and effects after kidney transplantation are unknown. We aimed to assess the prevalence of increased IAP and its impact on delayed graft function (DGF) in a sample of deceased-donor kidney transplant recipients.
*Methods: Prospective cohort study in a nephrology department of a tertiary referral teaching hospital. IAP was measured every 8h for the first 72h after transplant surgery using the urinary bladder technique (UnoMeter Abdo-Pressure kit). Intra-abdominal hypertension was defined as IAP ≥12 mmHg. DGF was defined as the use of dialysis within 7 days of transplantation.
*Results: 121 patients were included in the study. Mean IAP was 12.6±3.5 mmHg in the first 24h. Demographic, anthropometric and clinical data is summarized in Table 1. IAP was an independent risk factor of DGF in adjusted logistic regression analysis (OR: 1.214; 95%CI 1.072-1.375; P=0.002).
Table 1: Demographic and clinical characteristics of recipients and donors.
| No IAH | IAH | P Value | |
| N | 21 | 100 | |
| Age, years | 61 (46-68) | 62 (52-70) | 0.236 |
| Male sex, n (%) | 8 (38.1) | 73 (73) | 0.002 |
| Caucasians, n (%) | 21 (100) | 98 (98) | 0.513 |
| Dialysis vintage, months | 21 (11-47.5) | 22 (10-34) | 0.805 |
| BMI, kg/m2 | 22.9±3.8 | 26.4±3.6 | <0.001 |
| Polycystic kidney disease, n (%) | 3 (14.3) | 20 (20) | 0.544 |
| Peritoneal dialysis as RRT, n (%) | 13 (61.9) | 37 (37) | 0.035 |
| First kidney transplant, n (%) | 16 (76.2) | 87 (87) | 0.206 |
| Hypertension, n (%) | 17 (81) | 91 (91) | 0.176 |
| Diabetes, n (%) | 2 (9.5) | 21 (21) | 0.223 |
| Age (donor), years | 54 (35.5-62) | 65 (51-72) | 0.015 |
| Male sex (donor), n (%) | 15 (71.4) | 64 (64) | 0.516 |
| Stroke as cause of death (donor), n (%) | 11 (52.4) | 62 (62) | 0.413 |
| Serum creatinine (donor), mg/dl | 0.75 (0.64-0.89) | 0.78 (0.68-0.94) | 0.547 |
| Donation after cardiac death, n (%) | 1 (4.8) | 3 (3) | 0.681 |
| Surgery duration, min | 165 (158-208) | 185 (171-219) | 0.038 |
| Cold ischemia time, hours | 14 (12-19) | 16 (13-18) | 0.929 |
| Day 0 mean IAP, mmHg | 8.3±1.6 | 13.5±3.1 | <0.001 |
*Conclusions: Increased IAP was highly prevalent during the first hours after renal transplantation and was associated with higher rates of DGF. Routine IAP measurement should be considered after transplantation to facilitate early recognition of complications and institution of appropriate therapeutic interventions.
To cite this abstract in AMA style:
Coca A, Arias-Cabrales C, Perez-Saez M, Gonzalez P, Crespo M, Rollan M, Toribio B, Mendiluce A, Pascual J, Bustamante-Munguira J. Increased Intra-Abdominal Pressure is Associated with Delayed Graft Function after Kidney Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/increased-intra-abdominal-pressure-is-associated-with-delayed-graft-function-after-kidney-transplantation/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress