Submitted: 10 Dec 2019
Accepted: 05 Jan 2019
First published online: 29 Jan 2019
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J Renal Inj Prev. 2019;8(2):157-163.
doi: 10.15171/jrip.2019.29
  Abstract View: 268
  PDF Download: 290

Original

Risk factors for delayed graft function in deceased donor kidney transplantation; a potential preventive role for intraoperative thymoglobulin

Neda Naderi 1, Azam Alamdari 1 * , Mahboob Lessan-Pezeshki 1, Simin Dashti-Khavidaki 1, Mehran Heydari-Seradj 2, Armin Safdarpour 3, Hamid Moradi 4, Ahmad Mehdizadeh 5, Mohammad-Reza Khatami 1

1 Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 Shahed University, Tehran, Iran
3 Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, CA, USA
5 Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
*Corresponding author: Azam Alamdari, Email: Email: a-alamdari@sina.tums.ac.ir

Article

Introduction: Delayed graft function (DGF) is associated with significant adverse outcomes in deceased donor kidney transplantation (KT) including lower graft survival. However, risk factors and potential preventive strategies like intraoperative rabbit antithymocyte globulin (rATG; thymoglobulin) have not yet been fully evaluated.

Objectives: The aim of this study was to investigate DGF risk factors and determine the association of intraoperative rATG with the risk of DGF in deceased donor kidney recipients.

Patients and Methods: We retrospectively examined medical records of 163 first time deceased donor kidney transplant recipients at two major kidney transplant centers from 2014 to 2016. All the donors were standard heart-beating, brain death donors. Risk factors for DGF in recipients were evaluated using multivariate logistic regression analysis.

Results: The mean recipients’ age was 43±13 years and the majority of participants were male (64%). The overall rate of DGF was 27%. Intraoperative rATG was significantly associated with a lower rate of DGF (adjusted odds ratio [AOR], 0.33, 95% CI, 0.11-0.95). Intraoperative transfusion (AOR, 3.7, 95% CI, 1.4-9.9) and diabetes mellitus (AOR, 3.7, 95% CI, 1.5-8.9) were significantly associated with higher risk of DGF.

Conclusion: This study showed that intraoperative blood transfusion and diabetes mellitus were associated with increased risk of DGF. Meanwhile, administration of intraoperative rATG was associated with reduced odds ratio of DGF. Future studies are needed to evaluate the potential role of rATG in DGF-related renal outcomes.

Implication for health policy/practice/research/medical education:

The aim of this study was to investigate DGF risk factors and determine the association of intraoperative rATG with the risk of DGF in deceased donor kidney recipients at our centers. This study showed that intraoperative rATG induction therapy was associated with decreased incidence of DGF in deceased donor kidney recipients. In addition, intraoperative blood transfusion and recipient diabetes were independent risk factors for DGF.

Please cite this paper as: Naderi N, Alamdari A, Lessan-Pezeshki M, Dashti-Khavidaki S, Heydari-Seradj M, Safdarpour A, et al. Risk factors for delayed graft function in deceased donor kidney transplantation; a potential preventive role for intraoperative thymoglobulin. J Renal Inj Prev. 2019; 8(2): 157-163. DOI: 10.15171/jrip.2019.29 

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