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Predictive Value of Delayed Graft Function Definitions Following Donation After Circulatory Death Renal Transplantation in the United Kingdom
Purpose: A variety of definitions for delayed graft function (DGF) have been proposed, but none has consistently been shown to be superior for predicting long-term graft outcomes for kidney donation after circulatory death (DCD) transplantation. In this study, real-world clinical outcome data follow...
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Published in: | Transplant research and risk management 2022-06, Vol.14, p.21-33 |
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creator | Stirnadel-Farrant, Heide A Mu, George Cooper-Blenkinsopp, Selin Schroyer, Rosemary O Thorneloe, Kevin S Harrison, Ewen M Andrews, Susan M.S |
description | Purpose: A variety of definitions for delayed graft function (DGF) have been proposed, but none has consistently been shown to be superior for predicting long-term graft outcomes for kidney donation after circulatory death (DCD) transplantation. In this study, real-world clinical outcome data following DCD transplantation were explored to determine the value of various DGF definitions for predicting graft survival. Patients and Methods: Data from 4 centers registered in the UK-based National Health Service Blood and Transplant registry (2010 to mid-2015) were used to assess 4 definitions of DGF in this retrospective chart review study. Results: Depending on the definition used, the frequency of DGF ranged from 119/362 (32.9%) when DGF was determined with available registry data and based on a requirement for dialysis within 7 days post-transplantation, to 224/315 (71.1%) when based on failure to achieve a 10% fall in serum creatinine (SCr) versus baseline per 24 hours averaged over the first 72 hours. Patients without clinical DGF as determined by a physician upon chart review, or when defined as |
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In this study, real-world clinical outcome data following DCD transplantation were explored to determine the value of various DGF definitions for predicting graft survival. Patients and Methods: Data from 4 centers registered in the UK-based National Health Service Blood and Transplant registry (2010 to mid-2015) were used to assess 4 definitions of DGF in this retrospective chart review study. Results: Depending on the definition used, the frequency of DGF ranged from 119/362 (32.9%) when DGF was determined with available registry data and based on a requirement for dialysis within 7 days post-transplantation, to 224/315 (71.1%) when based on failure to achieve a 10% fall in serum creatinine (SCr) versus baseline per 24 hours averaged over the first 72 hours. Patients without clinical DGF as determined by a physician upon chart review, or when defined as <30% reduction in baseline SCr within 7 days posttransplantation with or without dialysis, had significantly better graft survival probability 1 year (hazard ratio 2.08 and 4.48, respectively) and 5 years post-transplant, whereas serum creatinine level over the first 72 hours post-transplant was not predictive of graft survival at 1 year. Patients with clinical DGF upon physician chart review also had higher SCr, lower estimated glomerular filtration rate levels, and were dialyzed more (2.3 days) versus patients without (0.2 days). Conclusion: Delayed graft function, determined clinically or using a functional definition, is associated with poorer renal function and remains a useful predictor of graft survival at 1 year after DCD kidney transplantation. Keywords: delayed graft function, DGF, donation after circulatory death, DCD, serum creatinine, SCr</description><identifier>ISSN: 1179-1616</identifier><identifier>EISSN: 1179-1616</identifier><identifier>DOI: 10.2147/TRRM.S320221</identifier><language>eng</language><publisher>Dove Medical Press Limited</publisher><subject>dcd ; delayed graft function ; dgf ; donation after circulatory death ; Donation of organs, tissues, etc ; Gifts ; Kidneys ; scr ; serum creatinine ; Transplantation</subject><ispartof>Transplant research and risk management, 2022-06, Vol.14, p.21-33</ispartof><rights>COPYRIGHT 2022 Dove Medical Press Limited</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3091-b3a51ffc50ee64d45b988c309d52511534f7ed19b4f957a670d483170027d6083</cites><orcidid>0000-0001-8977-3189</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Stirnadel-Farrant, Heide A</creatorcontrib><creatorcontrib>Mu, George</creatorcontrib><creatorcontrib>Cooper-Blenkinsopp, Selin</creatorcontrib><creatorcontrib>Schroyer, Rosemary O</creatorcontrib><creatorcontrib>Thorneloe, Kevin S</creatorcontrib><creatorcontrib>Harrison, Ewen M</creatorcontrib><creatorcontrib>Andrews, Susan M.S</creatorcontrib><title>Predictive Value of Delayed Graft Function Definitions Following Donation After Circulatory Death Renal Transplantation in the United Kingdom</title><title>Transplant research and risk management</title><description>Purpose: A variety of definitions for delayed graft function (DGF) have been proposed, but none has consistently been shown to be superior for predicting long-term graft outcomes for kidney donation after circulatory death (DCD) transplantation. In this study, real-world clinical outcome data following DCD transplantation were explored to determine the value of various DGF definitions for predicting graft survival. Patients and Methods: Data from 4 centers registered in the UK-based National Health Service Blood and Transplant registry (2010 to mid-2015) were used to assess 4 definitions of DGF in this retrospective chart review study. Results: Depending on the definition used, the frequency of DGF ranged from 119/362 (32.9%) when DGF was determined with available registry data and based on a requirement for dialysis within 7 days post-transplantation, to 224/315 (71.1%) when based on failure to achieve a 10% fall in serum creatinine (SCr) versus baseline per 24 hours averaged over the first 72 hours. Patients without clinical DGF as determined by a physician upon chart review, or when defined as <30% reduction in baseline SCr within 7 days posttransplantation with or without dialysis, had significantly better graft survival probability 1 year (hazard ratio 2.08 and 4.48, respectively) and 5 years post-transplant, whereas serum creatinine level over the first 72 hours post-transplant was not predictive of graft survival at 1 year. Patients with clinical DGF upon physician chart review also had higher SCr, lower estimated glomerular filtration rate levels, and were dialyzed more (2.3 days) versus patients without (0.2 days). Conclusion: Delayed graft function, determined clinically or using a functional definition, is associated with poorer renal function and remains a useful predictor of graft survival at 1 year after DCD kidney transplantation. Keywords: delayed graft function, DGF, donation after circulatory death, DCD, serum creatinine, SCr</description><subject>dcd</subject><subject>delayed graft function</subject><subject>dgf</subject><subject>donation after circulatory death</subject><subject>Donation of organs, tissues, etc</subject><subject>Gifts</subject><subject>Kidneys</subject><subject>scr</subject><subject>serum creatinine</subject><subject>Transplantation</subject><issn>1179-1616</issn><issn>1179-1616</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNptUs1qGzEQXkoLDWlufQBBoafa0axWq92jceokNKXBcXpdxvqxFWQpSHKLHyLvHNkOJYFKBw3z_Qwavqr6DHRcQyPOF_P5z_Edq2ldw7vqBED0I2ihff-q_lidpfRAy-ko5ZyfVE-3USsrs_2jyW90W02CIRfa4U4rchnRZDLb-oIHX9rGersvE5kF58Jf61fkIng8wBOTdSRTG-XWYQ5xVwSY12SuPTqyiOjTo0Ofj2zrSV5rcl8My6QfxUmFzafqg0GX9NnLe1rdz74vplejm1-X19PJzUgy2sNoyZCDMZJTrdtGNXzZd90eUrzmAJw1RmgF_bIxPRfYCqqajoGgtBaqpR07ra6Pvirgw_AY7Qbjbghoh0MjxNWAMVvp9FB0THUCOTZQTCR2qq87zREF1EKz4vXl6LXCQrfehBxRbmySw0QAFdCwDgpr_B9WuUpvrAy-rLb03wi-vhKsNbq8TsFtD-t_S_x2JMoYUora_PsP0GGfjGGfjOElGewZ3VypjQ</recordid><startdate>20220630</startdate><enddate>20220630</enddate><creator>Stirnadel-Farrant, Heide A</creator><creator>Mu, George</creator><creator>Cooper-Blenkinsopp, Selin</creator><creator>Schroyer, Rosemary O</creator><creator>Thorneloe, Kevin S</creator><creator>Harrison, Ewen M</creator><creator>Andrews, Susan M.S</creator><general>Dove Medical Press Limited</general><general>Dove Medical Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8977-3189</orcidid></search><sort><creationdate>20220630</creationdate><title>Predictive Value of Delayed Graft Function Definitions Following Donation After Circulatory Death Renal Transplantation in the United Kingdom</title><author>Stirnadel-Farrant, Heide A ; Mu, George ; Cooper-Blenkinsopp, Selin ; Schroyer, Rosemary O ; Thorneloe, Kevin S ; Harrison, Ewen M ; Andrews, Susan M.S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3091-b3a51ffc50ee64d45b988c309d52511534f7ed19b4f957a670d483170027d6083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>dcd</topic><topic>delayed graft function</topic><topic>dgf</topic><topic>donation after circulatory death</topic><topic>Donation of organs, tissues, etc</topic><topic>Gifts</topic><topic>Kidneys</topic><topic>scr</topic><topic>serum creatinine</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stirnadel-Farrant, Heide A</creatorcontrib><creatorcontrib>Mu, George</creatorcontrib><creatorcontrib>Cooper-Blenkinsopp, Selin</creatorcontrib><creatorcontrib>Schroyer, Rosemary O</creatorcontrib><creatorcontrib>Thorneloe, Kevin S</creatorcontrib><creatorcontrib>Harrison, Ewen M</creatorcontrib><creatorcontrib>Andrews, Susan M.S</creatorcontrib><collection>CrossRef</collection><collection>Directory of Open Access Journals</collection><jtitle>Transplant research and risk management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stirnadel-Farrant, Heide A</au><au>Mu, George</au><au>Cooper-Blenkinsopp, Selin</au><au>Schroyer, Rosemary O</au><au>Thorneloe, Kevin S</au><au>Harrison, Ewen M</au><au>Andrews, Susan M.S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive Value of Delayed Graft Function Definitions Following Donation After Circulatory Death Renal Transplantation in the United Kingdom</atitle><jtitle>Transplant research and risk management</jtitle><date>2022-06-30</date><risdate>2022</risdate><volume>14</volume><spage>21</spage><epage>33</epage><pages>21-33</pages><issn>1179-1616</issn><eissn>1179-1616</eissn><abstract>Purpose: A variety of definitions for delayed graft function (DGF) have been proposed, but none has consistently been shown to be superior for predicting long-term graft outcomes for kidney donation after circulatory death (DCD) transplantation. In this study, real-world clinical outcome data following DCD transplantation were explored to determine the value of various DGF definitions for predicting graft survival. Patients and Methods: Data from 4 centers registered in the UK-based National Health Service Blood and Transplant registry (2010 to mid-2015) were used to assess 4 definitions of DGF in this retrospective chart review study. Results: Depending on the definition used, the frequency of DGF ranged from 119/362 (32.9%) when DGF was determined with available registry data and based on a requirement for dialysis within 7 days post-transplantation, to 224/315 (71.1%) when based on failure to achieve a 10% fall in serum creatinine (SCr) versus baseline per 24 hours averaged over the first 72 hours. Patients without clinical DGF as determined by a physician upon chart review, or when defined as <30% reduction in baseline SCr within 7 days posttransplantation with or without dialysis, had significantly better graft survival probability 1 year (hazard ratio 2.08 and 4.48, respectively) and 5 years post-transplant, whereas serum creatinine level over the first 72 hours post-transplant was not predictive of graft survival at 1 year. Patients with clinical DGF upon physician chart review also had higher SCr, lower estimated glomerular filtration rate levels, and were dialyzed more (2.3 days) versus patients without (0.2 days). Conclusion: Delayed graft function, determined clinically or using a functional definition, is associated with poorer renal function and remains a useful predictor of graft survival at 1 year after DCD kidney transplantation. Keywords: delayed graft function, DGF, donation after circulatory death, DCD, serum creatinine, SCr</abstract><pub>Dove Medical Press Limited</pub><doi>10.2147/TRRM.S320221</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-8977-3189</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | dcd delayed graft function dgf donation after circulatory death Donation of organs, tissues, etc Gifts Kidneys scr serum creatinine Transplantation |
title | Predictive Value of Delayed Graft Function Definitions Following Donation After Circulatory Death Renal Transplantation in the United Kingdom |
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