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Organo Oficial de la Sociedad Mexicana de Urología

2023, Número 3

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Rev Mex Urol 2023; 83 (3)


Factores predictores para la función retardada del injerto renal: estudio retrospectivo

Ornelas-Aguirre JM, Jiménez-Rodríguez MJ, Arias-Constantino JM, Gurrola-Castillo A, Ochoa-Parra KA

Idioma: Español
Referencias bibliográficas: 35
Paginas: 1-15
Archivo PDF: 491.43 Kb.


RESUMEN

Objetivo: Conocer la frecuencia y factores asociados a la función retar- dada del injerto (FRI) renal en un centro de tercer nivel de atención en el noroeste de México.
Metodología: Se revisó la información de los trasplantes renales de 2015 a 2017, la FRI y aquellas variables clínicas involucradas dentro de la primera semana posterior al procedimiento mediante un análisis de regresión logística.
Resultados: FRI ocurrió en 11% (IC 95% 7 a 15) de 199 trasplantes. Los factores de riesgo asociados con FRI incluyeron: terapia de sustitución renal combinada (OR: 3.50; IC 95%: 1.39 a 8.78; p=0.005), donador cadavérico (OR: 8.06; IC 95%: 1.82 a 35.53; p=0.001), afección cardio- vascular (OR: 4.32; IC 95%: 0.74 a 25.12; p=0.07) y rechazo agudo (OR: 2.78; IC 95%: 0.98 a 7.90; p=0.04). El análisis multivariable reveló como factores independientes para FRI la terapia de sustitución renal com- binada (OR: 3.34; p=0.01) y donador cadavérico (OR: 8.02; p=0.007).
Conclusiones: Los factores asociados a FRI que se observaron en este estudio están relacionados tanto con el receptor del riñón como con el donante. Se requieren de nuevos estudios prospectivos que permitan conocer la influencia que tienen los diversos factores conocidos para el desarrollo de FRI y el pronóstico del órgano trasplantado.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Kernig K, Albrecht V, Dräger D-L, Führer A, Mitzner S, Kundt G, et al. Predictors of Delayed Graft Function in Renal Transplantation. Urol Int. 2022;106(5):512–7. doi: https://doi. org/10.1159/000520055

  2. Hogendorf P, Suska A, Skulimowski A, Rut J, Grochowska M, Wencel A, et al. Neutrophil- lymphocyte ratio and creatinine reduction ratio predict good early graft function among adult cadaveric donor renal transplant recipients. Single institution series. Pol Przegl Chir. 2018;90(2):28–33. doi: https://doi. org/10.5604/01.3001.0011.7499

  3. Schiavelli R, Rosés J, Di Tullio D, Gautos A, Sabbatiello R, Pattin M, et al. Retraso de la función del injerto en trasplante renal. Rev nefrol diál traspl. 2015;182–7.

  4. Chen R, Wang H, Song L, Hou J, Peng J, Dai H, et al. Predictors and one-year outcomes of patients with delayed graft function afterdeceased donor kidney transplantation. BMC Nephrol. 2020;21(1):526. doi: https://doi. org/10.1186/s12882-020-02181-1

  5. Szwarc I, Garrigue V, Delmas S, Deleuze S, Chong G, Mourad G. La reprise retardée de fonction: une complication fréquente, non résolue, en transplantation rénale. Néphrologie & Thérapeutique. 2005;1(6):325–34. doi: https://doi.org/10.1016/j.nephro.2005.08.003

  6. Yarlagadda SG, Coca SG, Garg AX, Doshi M, Poggio E, Marcus RJ, et al. Marked variation in the definition and diagnosis of delayed graft function: a systematic review. Nephrology Dialysis Transplantation. 2008;23(9):2995– 3003. doi: https://doi.org/10.1093/ndt/gfn158

  7. Bromberg JS, Weir MR, Gaber AO, Yamin MA, Goldberg ID, Mayne TJ, et al. Renal Function Improvement Following ANG-3777 Treatmentin Patients at High Risk for Delayed Graft Function After Kidney Transplantation. Transplantation. 2021;105(2):443–50. doi: https://doi. org/10.1097/tp.0000000000003255

  8. Sung RS, Guidinger MK, Leichtman AB, Lake C, Metzger RA, Port FK, et al. Impact of the Expanded Criteria Donor Allocation System on Candidates for and Recipients of Expanded Criteria Donor Kidneys. Transplantation. 2007;84(9):1138–44. doi: https://doi. org/10.1097/01.tp.0000287118.76725.c1

  9. Kolonko A, Chudek J, Wiecek A. Nephron Underdosing as a Risk Factor for Impaired Early Kidney Graft Function and Increased Graft Loss During the Long-Term Follow- up Period. Transplantation Proceedings. 2013;45(4):1639–43. doi: https://doi. org/10.1016/j.transproceed.2012.12.019

  10. Pérez Valdivia MA, Gentil MA, Toro M, Cabello M, Rodríguez-Benot A, Mazuecos A, et al. Impact of Cold Ischemia Time on Initial Graft Function and Survival Rates inRenal Transplants From Deceased Donors Performed in Andalusia. Transplantation Proceedings. 2011;43(6):2174–6. doi: https:// doi.org/10.1016/j.transproceed.2011.06.047

  11. Marzouk K, Lawen J, Alwayn I, Kiberd BA. The impact of vascular anastomosis time on early kidney transplant outcomes. Transplant Res. 2013;2(1):8. doi: https://doi. org/10.1186/2047-1440-2-8

  12. Shoskes DA, Cecka JM. Deleterious effects of delayed graft function in cadaveric renal transplant recipients independent of acute rejection 1,2,3: Transplantation. 1998;66(12):1697–701. doi: https://doi. org/10.1097/00007890-199812270-00022

  13. Le Dinh H, Weekers L, Bonvoisin C, Krzesinski JM, Monard J, De Roover A, et al. Delayed Graft Function Does Not Harm the Future of Donation-After-Cardiac Death in Kidney Transplantation. Transplantation Proceedings. 2012;44(9):2795–802. doi: https://doi. org/10.1016/j.transproceed.2012.09.087

  14. Salazar Meira F, Zemiacki J, Figueiredo AE, Viliano Kroth L, Saute Kochhann D, d’Avila DO, et al. Factors Associated With Delayed Graft Function and Their Influence on Outcomes of Kidney Transplantation. Transplantation Proceedings. 2016;48(7):2267–71. doi: https:// doi.org/10.1016/j.transproceed.2016.06.007

  15. De Sandes-Freitas TV, Felipe CR, Aguiar WF, Cristelli MP, Tedesco-Silva H, Medina- Pestana JO. Prolonged Delayed Graft Function Is Associated with Inferior Patient and Kidney Allograft Survivals. Stepkowski S, editor. PLoS ONE. 2015;10(12):e0144188. doi: https://doi. org/10.1371/journal.pone.0144188

  16. Zhang H, Fu Q, Liu J, Li J, Deng R, Wu C, et al. Risk factors and outcomes of prolonged recovery from delayed graft function after deceased kidney transplantation. Renal Failure.2020;42(1):792–8. doi: https://doi.org/10.1080/0886022x.2020.1803084

  17. Instituto Mexicano del Seguro Social. Guía de Práctica Clínica GPC Terapia Inmunosupresora en el Trasplante Renal. Instituto Mexicano del Seguro Social; 2009.

  18. Drinka PJ, Langer E. The Cockroft-Gault Formula. Journal of the American Geriatrics Society. 1989;37(8):820–820. doi: https://doi. org/10.1111/j.1532-5415.1989.tb02250.x

  19. Yeo Y, Han D-J, Moon DH, Park JS, Yang WS, Chang JW, et al. Suitability of the IDMS-Traceable MDRD Equation Method to Estimate GFR in Early Postoperative Renal Transplant Recipients. Nephron Clin Pract. 2009;114(2):c108–17. doi: https://doi. org/10.1159/000254383

  20. Soares AA, Eyff TF, Campani RB, Ritter L, Camargo JL, Silveiro SP. Glomerular filtration rate measurement and prediction equations. Clinical Chemistry and Laboratory Medicine. 2009;47(9). Doi: https://doi.org/10.1515/ cclm.2009.263

  21. Loupy A, Haas M, Roufosse C, Naesens M, Adam B, Afrouzian M, et al. The Banff 2019 Kidney Meeting Report (I): Updates on and clarification of criteria for T cell– and antibody-mediated rejection. American Journal of Transplantation. 2020;20(9):2318–31. doi: https://doi.org/10.1111/ajt.15898

  22. Pérez-Gutiérrez A, Morales-Buenrostro LE, Vilatobá-Chapa M, Mendoza-De-la-Garza Á, Vega-Vega O, Gabilondo-Pliego B, et al. Factores de riesgo para el desarrollo de función retardada del injerto en receptores de trasplante renal de donante fallecido y su impacto en la supervivencia de paciente e injerto. Rev Invest Clin. 2013;65(2):109–15.

  23. Ghidini F, De Corti F, Fascetti Leon F, Vidal E, Rancan A, Parolin M, et al. Extraperitonealkidney transplantation: a comparison betweenchildren weighting ≤15 kg and >15 kg.Experience of a single institution. TransplInt. 2021;34(11):2394–402. doi: https://doi.org/10.1111/tri.14015

  24. Bahl D, Haddad Z, Datoo A, Qazi YA. Delayedgraft function in kidney transplantation.Current Opinion in Organ Transplantation.2019;24(1):82–6. doi: https://doi.org/10.1097/mot.0000000000000604

  25. Saidi RF, Elias N, Kawai T, Hertl M, FarrellM-L, Goes N, et al. Outcome of KidneyTransplantation Using Expanded CriteriaDonors and Donation After Cardiac DeathKidneys: Realities and Costs. AmericanJournal of Transplantation. 2007;7(12):2769–74. doi: https://doi.org/10.1111/j.1600-6143.2007.01993.x

  26. Yarlagadda SG, Coca SG, Formica RN,Poggio ED, Parikh CR. Association betweendelayed graft function and allograft andpatient survival: a systematic review and metaanalysis.Nephrology Dialysis Transplantation.2008;24(3):1039–47. doi: https://doi.org/10.1093/ndt/gfn667

  27. Hekmat R, Sturdevant M. A study of themain determinants of kidney allograft longtermsurvival in the era of newimmunosuppressive drugs. Saudi J KidneyDis Transpl. 2019;30(3):640. doi: https://doi.org/10.4103/1319-2442.261338

  28. Ounissi M, Kheder A, Slama R, Sfar I, AbdallahT, Abderrahim E, et al. Risk factors andconsequences of delayed graft function. SaudiJ Kidney Dis Transpl. 2013;24(2):243. doi:https://doi.org/10.4103/1319-2442.109564

  29. Klein R, Galante NZ, De Sandes-Freitas TV, DeFranco MF, Tedesco-Silva H, Medina-PestanaJO. Transplantation With Kidneys RetrievedFrom Deceased Donors With Acute RenalFailure. Transplantation. 2013;95(4):611–6. doi:https://doi.org/10.1097/tp.0b013e318279153c

  30. Dinh A, Ku E. Pretransplant dialysis exposureand outcomes after kidney transplantation –Where quantity and quality intersect? AmericanJournal of Transplantation. 2020;20(9):2301–2.doi: https://doi.org/10.1111/ajt.16007

  31. Balzer MS, Pankow S, Claus R, Dumann E,Ruben S, Haller H, et al. Pretransplant dialysismodality and long-term patient and kidneyallograft outcome: a 15-year retrospectivesingle-centre cohort study. TransplantInternational. 2020;33(4):376–90. doi: https://doi.org/10.1111/tri.13552

  32. Joseph J, Jindal R. Influence of dialysis onpost-transplant events: Influence of dialysis.Clinical Transplantation. 2002;16(1):18–23. doi: https://doi.org/10.1034/j.1399-0012.2002.00069.x

  33. Gill JS, Clark S, Kadatz M, Gill J. Theassociation of pretransplant dialysis exposurewith transplant failure is dependent on the statespecificrate of dialysis mortality. AmericanJournal of Transplantation. 2020;20(9):2481–90. doi: https://doi.org/10.1111/ajt.15917

  34. Legendre C, Canaud G, Martinez F. Factorsinfluencing long-term outcome after kidneytransplantation. Transpl Int. 2014;27(1):19–27.doi: https://doi.org/10.1111/tri.12217

  35. Foroutan F, Friesen EL, Clark KE, MotaghiS, Zyla R, Lee Y, et al. Risk Factors for 1-YearGraft Loss After Kidney Transplantation:Systematic Review and Meta-Analysis. CJASN.2019;14(11):1642–50. doi: https://doi.org/10.2215/cjn.05560519




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