BACKGROUND: This study compared 22 different definitions of delayed graft function (DGF) following kidney transplantation. MATERIAL AND METHODS: Our study included 497 kidney transplantations from deceased donors at our center between 2005 and 2011. Graft survival analysis including log-rank tests and Cox proportional hazards model was performed. Sensitivity and specificity were calculated in relation to graft failure. RESULTS: Mean follow-up time was 5.1 years. All dialysis-based definitions were associated with graft failure and characterized by high specificity (88-97%), but low sensitivity (25-29%). Hazard ratios ranged from 2.87 to 13.73, with increased risk when dialysis was required earlier and more frequently. The urine output-based definition performed similarly, with an association with graft failure and high specificity (96%), but low sensitivity (21%). Serum creatinine-based definitions were more heterogeneous. Higher sensitivity (4-67%) was found in some of these definitions, but was often associated with lower specificity (47-96%), losing the association with graft failure. Definitions combining different criteria varied in sensitivity (17-62%) and specificity (60-96%). However, some were able to achieve higher sensitivity without compromising too much on specificity, while keeping the association with graft failure. CONCLUSIONS: Our results indicate a potential advantage of combined definitions, because they are able to detect a larger group of recipients with increased risk of graft failure.
BACKGROUND: This study compared 22 different definitions of delayed graft function (DGF) following kidney transplantation. MATERIAL AND METHODS: Our study included 497 kidney transplantations from deceased donors at our center between 2005 and 2011. Graft survival analysis including log-rank tests and Cox proportional hazards model was performed. Sensitivity and specificity were calculated in relation to graft failure. RESULTS: Mean follow-up time was 5.1 years. All dialysis-based definitions were associated with graft failure and characterized by high specificity (88-97%), but low sensitivity (25-29%). Hazard ratios ranged from 2.87 to 13.73, with increased risk when dialysis was required earlier and more frequently. The urine output-based definition performed similarly, with an association with graft failure and high specificity (96%), but low sensitivity (21%). Serum creatinine-based definitions were more heterogeneous. Higher sensitivity (4-67%) was found in some of these definitions, but was often associated with lower specificity (47-96%), losing the association with graft failure. Definitions combining different criteria varied in sensitivity (17-62%) and specificity (60-96%). However, some were able to achieve higher sensitivity without compromising too much on specificity, while keeping the association with graft failure. CONCLUSIONS: Our results indicate a potential advantage of combined definitions, because they are able to detect a larger group of recipients with increased risk of graft failure.
Authors: Maria Helena Calixto Fernandes; Thomas Schricker; Sheldon Magder; Roupen Hatzakorzian Journal: Crit Care Date: 2018-01-25 Impact factor: 9.097
Authors: Nicholas V Mendez; Yehuda Raveh; Joshua J Livingstone; Gaetano Ciancio; Giselle Guerra; George W Burke Iii; Vadim B Shatz; Fouad G Souki; Linda J Chen; Mahmoud Morsi; Jose M Figueiro; Tony M Ibrahim; Werviston L DeFaria; Ramona Nicolau-Raducu Journal: World J Transplant Date: 2021-04-18
Authors: Gertrude J Nieuwenhuijs-Moeke; Tobias M Huijink; Robert A Pol; Mostafa El Moumni; Johannes Gm Burgerhof; Michel Mrf Struys; Stefan P Berger Journal: J Clin Med Date: 2019-10-02 Impact factor: 4.241