PURPOSE OF REVIEW: Delayed graft function is an important determinant of patient and graft survival. A complex of pathologic mechanisms intervenes in the pathophysiology of this outcome. This paper reviews the main processes involved in delayed graft function as they relate to five chronologically related stages: donor tissue quality, brain death and related stress, preservation variables, immune factors, and recipient variables. RECENT FINDINGS: Dialyzed delayed graft function and nondialyzed slow graft function both have a negative impact on graft survival and on the incidence of acute rejection. Expanded-criteria donors, older donors, and non-heart-beating donors are more frequently used. The long-term results of the use of well-selected non-heart-beating donors are surprisingly good. The process of ischemia/reperfusion injury is already initiated in the brain-death donor and continues during preservation of the graft. Graft-infiltrating T cells, heat shock proteins, and heme oxygenase-1 are implicated in the process. Modifications in immunosuppressive therapy and pharmacologic modulations have an effect on delayed graft function. Delayed graft function plays a part in the incidence of acute rejection, impaired graft function, and survival of patients and grafts. SUMMARY: This review discusses the current literature on several recent findings of pathophysiologic mechanisms of, and possible therapeutic interventions in, delayed graft function.
PURPOSE OF REVIEW: Delayed graft function is an important determinant of patient and graft survival. A complex of pathologic mechanisms intervenes in the pathophysiology of this outcome. This paper reviews the main processes involved in delayed graft function as they relate to five chronologically related stages: donor tissue quality, brain death and related stress, preservation variables, immune factors, and recipient variables. RECENT FINDINGS: Dialyzed delayed graft function and nondialyzed slow graft function both have a negative impact on graft survival and on the incidence of acute rejection. Expanded-criteria donors, older donors, and non-heart-beating donors are more frequently used. The long-term results of the use of well-selected non-heart-beating donors are surprisingly good. The process of ischemia/reperfusion injury is already initiated in the brain-deathdonor and continues during preservation of the graft. Graft-infiltrating T cells, heat shock proteins, and heme oxygenase-1 are implicated in the process. Modifications in immunosuppressive therapy and pharmacologic modulations have an effect on delayed graft function. Delayed graft function plays a part in the incidence of acute rejection, impaired graft function, and survival of patients and grafts. SUMMARY: This review discusses the current literature on several recent findings of pathophysiologic mechanisms of, and possible therapeutic interventions in, delayed graft function.
Authors: Sri G Yarlagadda; Steven G Coca; Amit X Garg; Mona Doshi; Emilio Poggio; Richard J Marcus; Chirag R Parikh Journal: Nephrol Dial Transplant Date: 2008-04-11 Impact factor: 5.992
Authors: Anja Bienholz; Frank Petrat; Patricia Wenzel; Philipp Ickerott; Joel M Weinberg; Oliver Witzke; Andreas Kribben; Herbert de Groot; Thorsten Feldkamp Journal: Am J Physiol Renal Physiol Date: 2012-04-18
Authors: Tao Qiu; Zhi-Shun Wang; Xiu-Heng Liu; Hui Chen; Jiang-Qiao Zhou; Zhi-Yuan Chen; Min Wang; Guan-Jun Jiang; Lei Wang; Gang Yu; Long Zhang; Ye Shen; Lu Zhang; Li He; Hua-Xin Wang; Wen-Jing Zhang Journal: Exp Ther Med Date: 2017-03-08 Impact factor: 2.447
Authors: W M Bernhardt; U Gottmann; F Doyon; B Buchholz; V Campean; J Schödel; A Reisenbuechler; S Klaus; M Arend; L Flippin; C Willam; M S Wiesener; B Yard; C Warnecke; K-U Eckardt Journal: Proc Natl Acad Sci U S A Date: 2009-11-23 Impact factor: 11.205