TY - JOUR
T1 - Impact of Induction Therapy on Delayed Graft Function Following Kidney Transplantation in Mated Kidneys
AU - Butler, T.
AU - Hayde, N.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/10
Y1 - 2017/10
N2 - Background Delayed graft function (DGF) is defined as the need for dialysis within 1 week of transplantation and occurs in 20%–50% of deceased-donor kidney transplant recipients. Although recovery from DGF often occurs within a few days, many cases may take weeks to months before the transplant function begins. The delay in function increases the complexity of recipient care, makes the diagnosis of acute rejection more difficult, prolongs length of stay, and increases hospital costs. Although several authors have proposed nomograms to predict DGF, there is no identifiable strategy to ameliorate it, except for the possible use of a specific type of induction therapy called Thymoglobulin. Methods In this retrospective analysis we included 407 subjects, of which 76 were mated (left and right kidney transplanted at Montefiore from the same donor). We used conditional logistic regression analysis while adjusting for the mated kidneys. We adjusted for age, gender, and race a priori, as well as cold ischemia time. Results There was a 36% decrease in odds of DGF when Thymoglobulin was used as induction when compared with basiliximab in mated kidneys 0.64 (0.10–4.05) (odds ratio [OR] with 95% confidence interval [CI]). Conclusions Thymoglobulin did have a protective effect in these data when analyzed in mated kidneys, however, we need a larger amount of data to concretely conclude this effect.
AB - Background Delayed graft function (DGF) is defined as the need for dialysis within 1 week of transplantation and occurs in 20%–50% of deceased-donor kidney transplant recipients. Although recovery from DGF often occurs within a few days, many cases may take weeks to months before the transplant function begins. The delay in function increases the complexity of recipient care, makes the diagnosis of acute rejection more difficult, prolongs length of stay, and increases hospital costs. Although several authors have proposed nomograms to predict DGF, there is no identifiable strategy to ameliorate it, except for the possible use of a specific type of induction therapy called Thymoglobulin. Methods In this retrospective analysis we included 407 subjects, of which 76 were mated (left and right kidney transplanted at Montefiore from the same donor). We used conditional logistic regression analysis while adjusting for the mated kidneys. We adjusted for age, gender, and race a priori, as well as cold ischemia time. Results There was a 36% decrease in odds of DGF when Thymoglobulin was used as induction when compared with basiliximab in mated kidneys 0.64 (0.10–4.05) (odds ratio [OR] with 95% confidence interval [CI]). Conclusions Thymoglobulin did have a protective effect in these data when analyzed in mated kidneys, however, we need a larger amount of data to concretely conclude this effect.
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U2 - 10.1016/j.transproceed.2017.06.032
DO - 10.1016/j.transproceed.2017.06.032
M3 - Article
C2 - 28923618
AN - SCOPUS:85031718281
SN - 0041-1345
VL - 49
SP - 1739
EP - 1742
JO - Transplantation proceedings
JF - Transplantation proceedings
IS - 8
ER -