Vai ai contenuti. | Spostati sulla navigazione | Spostati sulla ricerca | Vai al menu | Contatti | Accessibilità

| Crea un account

Cesca, Eleonora (2012) Pediatric Kidney Transplant. Effect of brain-dead donor resuscitation on delayed graft function. [Tesi di dottorato]

Full text disponibile come:

[img]
Anteprima
Documento PDF
2049Kb

Abstract (inglese)

ABSTRACT
Introduction and Aim of the Study. Studies devoted to brain dead donor parameters are all based on adult populations. The aim of this study was to analyze the correlation of delayed graft function (DGF) with brain-dead donor variables in a population of 116 consecutive pediatric recipients and to compare the clinical outcomes of non-DGF versus DGF recipients.
Patients and Methods. We classified the recipients into two groups: group 0 (No. 11) with DGF and group 1 (No. 105) without DGF. Endpoints of the study were: DGF, 6 months graft function and short-term patient and graft survival. Multivariate analysis was performed to determine independent risk factors of DGF.
Results. Monovariate analysis of donor parameters showed that donor age above 15 years, gender combination female donor/male recipients, and vascular cause of donor brain death were risk factors for prolonged DGF. The multivariate logistic regression model confirmed as independent risk factors for DGF donor age > 15 years and gender combination female donor to male recipient. After 6 months follow-up, the DGF group showed worse graft function, as well as a smaller incidence of normal histological pattern at graft biopsies.
Conclusions. About parameters associated with brain-death donor resuscitation, except for non-traumatic cause of death, the others did not demonstrate any relationship with DGF. Importantly we show that donor age > 15 years and gender combination female donor to male recipient are clearly major independent risk factors for prolonged DGF in children. Furthermore in our paediatric series DGF revealed an important predictor of poor short-term graft function.

Abstract (italiano)

RIASSUNTO
Introduzione e scopo dello studio. In pazienti adulti, danni legati allo stato di morte cerebrale e alle manovre rianimatorie possono influenzare la ”delayed graft function” (DGF) e l‟outcome dell‟organo trapiantato. Scopo dello studio è stato valutare, in trapiantati di rene in età pediatrica, la correlazione tra parametri rianimatori del donatore cadavere e l‟outcome dell‟organo trapiantato.
Materiali e Metodi. Il campione casistico è consistito in 116 pazienti (età ≤ 16 anni), sottoposti a trapianto di rene da cadavere dal 2004 al 2011. I pazienti sono stati divisi in gruppo 0 (No. 11) con DGF e gruppo 1 (No. 105) senza DGF. Gli “endpoints” dello studio sono stati: DGF, funzione dell‟organo trapiantato a 6 mesi dal trapianto e sopravvivenza del paziente e del rene trapiantato a 6 mesi.
Risultati. L‟analisi monovariata dei parametri del donatore in morte cerebrale ha dimostrato che l‟età superiore a 15 anni, la combinazione donatore femmina/ricevente maschio e morte da accidente cerebrovascolare rappresentano fattori di rischio per lo sviluppo di DGF. Il modello di regressione logistica multivariata ha confermato come fattori di rischio indipendente per DGF l‟età del donatore e la combinazione donatore femmina/ricevente maschio. A 6 mesi di follow-up, il gruppo con DGF ha dimostrato una funzionalità renale e un quadro istologico bioptico significativamente peggiori rispetto al gruppo senza DGF.
Conclusioni. Ad eccezione della causa di morte non traumatica, nessuna variabile ha influenzato la DGF nei bambini trapiantati. L'età del donatore (>15 anni) e la combinazione donatore femmina/ricevente maschio si sono rivelati importanti fattori di rischio indipendente per lo sviluppo di DGF. Inoltre, la DGF è risultato un fattore predittivo di funzionalità a breve termine dell‟organo trapiantato.

Statistiche Download - Aggiungi a RefWorks
Tipo di EPrint:Tesi di dottorato
Relatore:Zanon, Giovanni Franco
Dottorato (corsi e scuole):Ciclo 24 > Scuole 24 > MEDICINA DELLO SVILUPPO E SCIENZE DELLA PROGRAMMAZIONE > SCIENZE CHIRURGICHE PEDIATRICHE E SPERIMENTALI
Data di deposito della tesi:30 Gennaio 2012
Anno di Pubblicazione:30 Gennaio 2012
Parole chiave (italiano / inglese):Peditric Kidney transplantation, brain-dead donor resuscitation
Settori scientifico-disciplinari MIUR:Area 06 - Scienze mediche > MED/20 Chirurgia pediatrica e infantile
Struttura di riferimento:Dipartimenti > pre 2012 - Dipartimento di Pediatria
Codice ID:4863
Depositato il:31 Ott 2012 12:31
Simple Metadata
Full Metadata
EndNote Format

Bibliografia

I riferimenti della bibliografia possono essere cercati con Cerca la citazione di AIRE, copiando il titolo dell'articolo (o del libro) e la rivista (se presente) nei campi appositi di "Cerca la Citazione di AIRE".
Le url contenute in alcuni riferimenti sono raggiungibili cliccando sul link alla fine della citazione (Vai!) e tramite Google (Ricerca con Google). Il risultato dipende dalla formattazione della citazione.

REFERENCES Cerca con Google

- Almond PS, Troppmann C, Escobar F, et al Economic impact of delayed graft function. Transplant Proc 1991: 23: 1304. Cerca con Google

- Benck U, Gottmann U, Hoeger S, et al. Donor Desmopressin Is Associated With Superior Graft Survival After Kidney Transplantation. Transplantation 2011: 92: 1252-1258. Cerca con Google

- Boom H, Mallat MJ, de Fijter JW, et al. Delayed graft function influences renal function, but not survival. Kidney Int 2000: 58: 859. Cerca con Google

- Boom H, Mallat MJ, de Fijter JW, et al. Delayed graft function influences renal function, but not survival. Kidney Int 2000: 58: 859-866. Cerca con Google

- Briscoe DM, Sayegh MH. A rendevouz before rejection: Where do T-cells meet transplant antigens? Nature Medicine 2002: 8: 220-221. Cerca con Google

- Chatziantoniou C, Dussaule JC. Is kidney injury a reversible process? Curr Opin Nephrol Hypertens 2008: 17: 76. Cerca con Google

- Cittanova ML, Leblanc I, Legendre C, et al. Effect of hydroxyethylstarch in brain-dead kidney donors on renal function in kidney-transplant recipients. Lancet 1996: 348: 1620. Cerca con Google

- Coronel B, Laurent V, Mercatello A, et al. Can hydroxyethylamidon be used during intensive care of brain-dead organ donors? Ann Fr Anesth Reanim 1994: 13: 10. Cerca con Google

References 53 Cerca con Google

- Cosio FG, Elkhammas EA, Henry ML, et al. Function and survival of renal allografts from the same donor transplanted into kidney-only or kidney-pancreas recipients. Transplantation 1998: 65: 93. Cerca con Google

- Cosio FG, Qiu W, Henry ML et al. Factors related to the donor organ are major determinants of renal allograft function and survival. Transplantation 1996: 62: 1571-1576. Cerca con Google

- Dubourg L, Cochat P, Hadj-Ai¨Ssa A, et al. Better long-term functional adaptation to the child‟s size with pediatric compared to adult kidney donors. Kidney International 2002: 62: 1454-1460. Cerca con Google

- EBPG Expert Group on Renal Transplantation. European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. IV.11 Paediatrics (specific problems). Nephrol Dial Transplant. 2002: 17 Suppl 4: 55-58. El Maghraby TA, Boom H, Camps JA, et al: Delayed graft function is characterized by reduced functional mass measured by (99m)Technetium-mercaptoacetyltriglycine renography. Transplantation 2002: 74: 203-208. Cerca con Google

- European Best Practise Guidelines for Renal Transplantation: Section IV: long-term management of the transplant recipient. IV.11 Paediatrics (specific problems). Nephrol Dial Transplant 2002: 17(suppl 4): 55. Cerca con Google

- Feduska NJ Jr, Cecka JM. Donor factors. Clin Transpl 1994: 381. Cerca con Google

- Feldman HI, Fozio I, Roth D. Recipient body size and cadaveric renal allograft survival. J Am Soc Nephrol 1996: 7: 151-154. Cerca con Google

References 54 Cerca con Google

- Feldman HI, Gayner R, Berlin JA, et al. Delayed function reduces renal allograft survival Independent of acute rejection. Nephrol Dial Transplant 1996: 11: 1306. Cerca con Google

- Gasser M, Waaga AM, Laskowski IA, et al. The influence of donor brain death on short and long-term outcome of solid organ allografts. Ann Transplant 2000: 5: 61. Cerca con Google

- Giral M, Bertola JP, Foucher Y, et al. Effect of Brain-Dead Donor Resuscitation on Delayed Graft Function: Results of a Monocentric Analysis Transplantation. 2007: 83. Cerca con Google

- Giral-Classe M, Hourmant M, Cantarovich D, et al. Delayed graft function of more than six days strongly decreases long-term survival of transplanted kidneys. Kidney Int 1998: 54: 972. Cerca con Google

- Giuliani S, Gamba PG, Chokshi NK, et al. The effect of donor/recipient body surface area ratio on outcomes in pediatric kidney transplantation. Pediatr Transplantation 2011: 15: 167-171. Cerca con Google

- Gjertson DW. A multi-factor analysis of kidney graft outcomes at one and five years posttransplantation: 1996 UNOS Update. Clin Transpl 1996, 343-360. Cerca con Google

- Gjertson DW. A multi-factor analysis of kidney graft outcomes at one and five years post-transplantation: 1996 UNOS update. In: Cecka JM, Terasaki PI (eds). Clinical Transplants. Los Angeles, USA - UCLA Tissue Typing Laboratory; 1996: 343-360. Cerca con Google

References 55 Cerca con Google

- Gourishankar S, Jhangri GS, Cockfield SM, et al. Donor tissue characteristics influence cadaver kidney transplant function and graft survival but not rejection. J Am Soc Nephrol 2003: 14: 493. Cerca con Google

- Gridelli B, Remuzzi G. Strategies for making more organs available for transplantation. N Engl J Med 2000: 343: 404-410. Cerca con Google

- Guesde R, Barrou B, Leblanc I, et al. Administration of desmopressin in brain-dead donors and renal function in kidney recipients. Lancet 1998: 352: 1178. Cerca con Google

- Halloran PF, Aprile MA, Farewell V et al. Early function as the principal correlate of graft survival: a multivariate analysis of 200 cadaveric renal transplants treated with a protocol incorporating antilymphocyte globulin and cyclosporine. Transplantation 1988: 46: 223-228. Cerca con Google

- Halloran PF, Hunsicker LG. Delayed graft function: state of the art, November 10-11, 2000. Summit meeting, Scottsdale, Arizona, USA. Am J Transplant 2001: 1: 115-120. Cerca con Google

- Hariharan S, McBride MA, Cherikh WS, et al. Post-transplant renal function in the first year predicts long-term kidney transplant survival. Kidney Int 2002: 62: 311-331. Cerca con Google

- Humar A, Ramcharan T, Kandaswamy R, et al. Risk factors for slow graft function after kidney transplants: a multivariate analysis. Clin Transplant 2002: 16: 425. Cerca con Google

References 56 Cerca con Google

- Iglesias-Marquez RA, Santiago-Delpin EA, Zayas E, et al. Delayed Graft Function in kidney transplant recipient: risk factors and short term outcome. Pransplantation Proceedings 2002: 34: 352-354. Cerca con Google

- Irish WD, McCollum DA, Tesi RJ, et al. Nomogram for predicting the likelihood of delayed graft function in adult cadaveric renal transplant recipients. J Am Soc Nephrol 2003: 14: 2967. Cerca con Google

- Jung GO, Yoon MR, Kim SJ, et al. The Risk Factors of Delayed Graft Function and Comparison of Clinical Outcomes After Deceased Donor Kidney Transplantation: Single-Center Study. Transplantation Proceedings 2010: 42: 705-709. Cerca con Google

- Keith DS, Demattos A, Golconda M, et al. Effect of donor recipient age match on survival after first deceased donor renal transplantation. J Am Soc Nephrol 2004: 15: 1086. Cerca con Google

- Kelly DA. Current issues in pediatric transplantation. Pediatr Transplantation 2006: 10: 712-720. Cerca con Google

- Küss R. The history of kidney transplantation. Prog Urol 1996: 6: 677-682. Cerca con Google

- Kyllonen LE, Salmela KT, Eklund BH et al. Long-term results of 1047 cadaveric kidney transplantations with special emphasis on initial graft function and rejection. Transpl Int 2000: 13: 122-128. Cerca con Google

- Kyllonen LE, Salmela KT, Eklund BH et al. Long-term results of 1047 cadaveric kidney transplantations with special emphasis on initial graft function and rejection. Transplant Int 2000: 13: 122-128. Cerca con Google

References 57 Cerca con Google

- Kyllonen LE, Salmela KT, Eklund BH, et al. Long-term results of 1047 cadaveric kidney transplantations with special emphasis on initial graft function and rejection. Transpl Int 2000: 13: 122-128. Cerca con Google

- Latimer JK. The action of testosterone propionate upon the kidneys of rats, dogs and men. J Urol 1942: 48: 778-794. Cerca con Google

- Lee LS, Auersvald LA, Claus EB, et al. Body size mismatch between donor and recipient and the development of chronic rejection in renal transplantation. Transplant Proc 1997:29: 111. Cerca con Google

- Marcen R, Oro®no L, de Pascual J et al. Delayed graft function does not reduce the survival of renal transplant allografts. Transplantation 1998: 66: 461-466. Cerca con Google

- Marshall R, Ahsan N, Dhillon S, et al. Adverse effect of donor vasopressor support on immediate and one-year kidney allograft function. Surgery 1996: 120: 663-665. Cerca con Google

- McLaren AJ, Jassem W, Gray DW, et al. Delayed graft function: risk factors and the relative effects of early function and acute rejection on long-term survival in cadaveric renal transplantation. Clin Transplant 1999: 13: 266. Cerca con Google

- Naesens M, Kambham N, Concepcion W, et al. The Evolution of Nonimmune Histological Injury and Its Clinical Relevance in Adult-Sized Kidney Grafts in Pediatric Recipients. American Journal of Transplantation 2007: 7: 2504-2514. Cerca con Google

References 58 Cerca con Google

- Neugarten J, Srinivas T, Tellis V, et al. The effect of donor gender on renal allograft survival. J Am Soc Nephrol 1996: 7: 318-324. Cerca con Google

- Nyengaard JR, Bendtsen TF. Glomerular number and size in relation to age, kidney weight and body surface area in normal man. Anat Rec 1992: 232: 194-201. Cerca con Google

- Offner G, Latta K, Hoyer PF. Kidney transplanted childern come of age. Kidney Int 1999: 55: 1509-1517. Cerca con Google

- Ojo AO, Hanson JA, Wolfe RA, et al. Long-term survival in renal transplant recipients with graft function. Delayed graft function does not reduce the survival of renal transplant allografts. Kidney Int 2000: 57: 307-313. Cerca con Google

- Ojo AO, Leichtman AB, Punch JD, et al. Impact of pre-existing donor hypertension and diabetes mellitus on cadaveric renal transplant outcomes. Am J Kidney Dis 2000: 36: 153. Cerca con Google

- Ojo AO, Wolfe RA, Held PJ, et al. Delayed graft function: Risk factors and implications for renal allograft survival. Transplantation 1997: 63: 968. Cerca con Google

- Opelz G, Dohler B. Cyclosporine and long-term kidney graft survival. Transplantation 2001: 72: 1267. Cerca con Google

- Pape L, Hoppe J, Becker T, et al. Superior long-term graft function and better growth of grafts in children receiving kidneys from paediatric compared with adult donors. Nephrol Dial Transplant 2006: 21: 2596-2600. Cerca con Google

References 59 Cerca con Google

- Parada B, Figueiredo A, Nunes P, et al. Pediatric renal transplantation: comparative study with renal transplantation in the adult population. Transplant Proc 2005: 37: 2771-2774. Cerca con Google

- Pelletier SJ, Guidinger MK, Merion RM, et al. Recovery and utilization of deceased donor kidneys from small pediatric donors. Am J Transplant 2006: 6: 1646-1652. Cerca con Google

- Perico N, Cattaneo D, Sayegh MH, et al. Delayed graft function in kidney transplantation. Lancet 2004: 364: 1814. Cerca con Google

- Pessione F, Cohen S, Durand D, et al. Multivariate analysis of donor risk factors for graft survival in kidney transplantation. Transplantation 2003: 75: 361. Cerca con Google

- Pfaff WW, Howard RJ, Patton PR, et al. Delayed graft function after renal transplantation. Transplantation 1998: 65: 219. Cerca con Google

- Poggio ED, Hila S, Stephany B, et al. Donor kidney volume and outcomes following live donor kidney transplantation. Am J Transplant 2006: 6: 616-624. Cerca con Google

- Pourmand G, Taheri M, Mehrsai AR, et al. Impact of donor nephron mass on outcome in renal transplantation. Transplant Proc 2001: 33: 2828-2829. Cerca con Google

- Pratschke J, Wilhelm MJ, Kusaka M, et al. Brain death and its influence on donor organ quality and outcome after transplantation. Transplantation 1999: 67: 343. Cerca con Google

References 60 Cerca con Google

- Pratschke J, Wilhelm MJ, Laskowski I et al. Influence of donor brain death on chronic rejection of renal transplants in rats. J Am Soc Nephrol 2001: 12: 2474-2481. Cerca con Google

- Quiroga I, McShane P, Koo DDH, et al. Major effects of delayed graft function and cold ischaemia time on renal allograft servival. Nephrol Dial Transplant 2006: 21: 1689-1696. Cerca con Google

- Remuzzi G, Grinyo J, Ruggenenti P, et al. Early experience with dual kidney transplantation in adults using expanded donor criteria. J Am Soc Nephrol 1999: 10: 2591-2598. Cerca con Google

- Rodrigo E, Ruiz JC, Pinera C, et al. Creatinine reduction ratio on post-transplant day two as criterion in defining delayed graft function. Am J Transplant 2004: 4: 1163. Cerca con Google

- Rosenthal JT, Danovitch GM, Wilkinson A, et al. The high cost of delayed graft function in cadaveric renal transplantation. Transplantation 1991: 51: 1115-1118. Cerca con Google

- Sabiston DC. Textbook of Surgery: The biological basis of modern surgical practice. 15 ed. Philadelphia, USA - WB Saunders Company; 1997: 382-389. Cerca con Google

- Sanchez-Fructuoso AI, Prats D, Marques M, et al. Does renal mass exert an independent effect on the determinants of antigen-dependent injury? Transplantation 2001: 71: 381-386. Cerca con Google

References 61 Cerca con Google

- Sarwal M, Cecka JM, Millan MT, et al. Adultsize kidneys without acute tubular necrosis provide exceedingly superior long-term graft outcomes for infants and small children. Transplantation 2000: 70: 1728-1736. Cerca con Google

- Schnuelle P, Berger S, de Boer J, et al. Donor employment of vasopressors and its impact on allograft survival after transplantation. Transplant Proc 2001: 33: 1282. Cerca con Google

- Schwartz GJ, Haycock GB, Edelmann CM Jr, et al. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 1976: 58: 259-263. Cerca con Google

- Shoskes DA, Cecka JM. Deleterious effects of delayed graft function in cadaveric renal transplant recipients independent of acute rejection. Transplantation 1998: 66: 1697. Cerca con Google

- Shoskes DA, Cecka JM. Deleterious effects of delayed graft function in cadaveric renal transplant recipients independent of acute rejection. Transplantation 1998 : 66: 1697-1701. Cerca con Google

- Smith JM, McDonald RA. Renal transplant outcomes in adolescents: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Pediatr Transpl 2002: 6: 493. Cerca con Google

- Solez K, Racusen LC, Olsen S. Morphologic differences between acute tubular necrosis in transplanted and native kidneys. In: Solez K and Racusen LC (eds). Acute Renal Failure: Diagnosis, Treatment and Prevention. New York, USA - Marcel Dekker, Inc; 1991: 3-12. Cerca con Google

References 62 Cerca con Google

- Solez K, Colvin RB, Racusen LC, et al. Banff 07 Classification of Renal Allograft Pathology: Updates and Future Directions. American J Transplantation 2008: 8: 753-760. Cerca con Google

- Su X, Zenios SA, Chakkera H, et al. Diminishing significance of HLA matching in kidney transplantation. Am J Transplant 2004: 4: 1501-1508. Cerca con Google

- Su X, Zenios SA, Chakkera H, et al. Diminishing significance of HLA matching in kidney transplantation. Am J Transplant 2004: 4: 1501-1508. Cerca con Google

- Suri D, Meyer TW. Influence of donor factors on early function of graft kidneys. J Am Soc Nephrol 1999: 10: 1317. Cerca con Google

- Taal MW, Tilney NL, Brenner BM, et al. Renal mass: An important determinant of late allograft outcome. Transplant Rev 1998: 12: 74-84. Cerca con Google

- Tejani AH, Fine RN, Harmon W (eds). Pediatric Solid Organ Transplantation. Copenhagen, Denmark - Munksgraad; 2000. Cerca con Google

- Terasaki PI, Cecka JM, Gjertson DW, et al. Risk rate and long-term kidney transplant survival. In: Cecka JM, Terasaki PI (eds). Clinical Transplants. Los Angeles, USA - UCLA Tissue Typing Laboratory; 1996: 443. Cerca con Google

- Troppmann C, Gillingham KJ, Benedetti E, et al. Delayed graft function, acute rejection, and outcome after cadaver renal transplantation. The multivariate analysis. Transplantation 1995: 59: 962. Cerca con Google

- Van den Eijnden MM, Leuvenink HG, Ottens PJ, et al. Effect of brain death and non-heart-beating kidney donation on renal function and injury: An Cerca con Google

References 63 Cerca con Google

assessment in the isolated perfused rat kidney. Exp Clin Transplant 2003: 1: 85. Cerca con Google

- Van der Hoeven JA, Molema G, Ter Horst GJ, et al. Relationship between duration of brain death and hemodynamic (in)stability on progressive dysfunction and increased immunologic activation of donor kidneys. Kidney Int 2003: 64: 1874. Cerca con Google

- Vereerstraeten P, Wissing M, De Pauw L, et al. Male recipients of kidneys from female donors are at increased risk of graft loss from both rejection and technical failure. Clin Transplant 1999: 13: 181-186. Cerca con Google

- Vincenti F. A decade of progress in kidney transplantation. Transplantation 2004: 77 (9 Suppl): S52. Cerca con Google

- www.ctstransplant.org Vai! Cerca con Google

- Yarlagadda SG, Coca SG, Formica Jr RN, et al. Association between delayed graft function and allograft and patient survival: a systematic review and meta-analysis. Nephrol Dial Transplant 2009: 24: 1039-1047. Cerca con Google

- Zeier M, Dohler B, Opelz G, et al. The effect of donor gender on graft survival. J Am Soc Nephrol 2002: 13: 2570 Cerca con Google

Download statistics

Solo per lo Staff dell Archivio: Modifica questo record