Kidney Week

Abstract: SA-PO017

Risk Factors for Delayed Graft Function in Deceased Donor Kidney Transplantation: Is Intra-Operative Thymoglobulin Preventive?

Session Information

• Transplantation: Clinical Outcomes
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Naderi, Neda, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)

Neda Naderi,

• Khatami, Mohammad reza, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)

Mohammad reza Khatami,

• Lessan-Pezeshki, Mahboob, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)

Mahboob Lessan-Pezeshki,

• Dashti-Khavidaki, Simin, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)

Simin Dashti-Khavidaki,

• Alamdari, Azam, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)

Azam Alamdari,

• Safdarpour, Armin, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)

Armin Safdarpour,

• Moradi, Hamid, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, California, United States

Hamid Moradi,

Background

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

Methods

We retrospectively examined medical records of 182 first time cadaveric kidney transplant recipients from two major kidney transplant centers from 2014-2016. Risk factors for DGF in recipients were evaluated using multivariate logistic regression analysis.

Results

The mean age was 43±13 years and the majority of participants were male (64%). The rate of intra-operative blood transfusion was 16%. The overall rate of DGF was 24.2%. Mean serum creatinine at discharge and length of hospital stay were significantly higher in patients with DGF compared with those without DGF (2.5 vs. 1.4 mg/dl and 25 vs. 14 days, respectively). Intra-operative ATG was significantly associated with a lower rate of DGF (adjusted odds ratio [AOR], 0.33, 95% CI, 0.11-0.95). Intra-operative 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. There was no statistically significant association between DGF and recipients’ age, sex, body mass index or duration of pre-transplant dialysis.

Conclusion

This study showed that intra-operative blood transfusion and diabetes mellitus were independent risk factors for the development of DGF. Meanwhile, administration of intra-operative ATG was associated with a reduced odds ratio of DGF. Future studies are needed to evaluate the potential role of ATG in DGF-related renal outcomes.