Scientific registry of transplant recipients
Scientific registry of transplant recipients
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DOI：
10.1111/j.1600-6143.2008.02157.x
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发表时间：
2008-04-01
影响因子：
8.8
通讯作者：
Port, F. K.
中科院分区：
文献类型：
--
作者：
Sung, R. S.;Christensen, L. L.;Port, F. K.
我们研究了与扩大标准供肾（ECD）肾丢弃相关的因素。移植受体科学登记处（SRTR）/器官获取和移植网络（OPTN）的数据进行了检查，供体因素使用逻辑回归，以确定调整后的比值比（AOR）的丢弃肾脏回收1999年10月至2005年6月。Logistic和考克斯回归模型用于确定与移植肾功能延迟恢复（DGF）和移植肾衰竭的相关性。在回收的12536个ECD肾脏中，5139个（41%）被丢弃。活检的表现（AOR = 1.21，p = 0.02）和活检时肾小球硬化（GS）的程度与丢弃几率的增加显著相关。GS与DGF或移植物衰竭无关。经泵ECD肾的弃肾率为29.7%，而未经泵ECD肾的弃肾率为43.6%（AOR = 0.52，p < 0.0001）。在泵肾中，阻力为0.26-0.38和> 0.38 mmHg/mL/min的肾比阻力为0.18-0.25 mmHg/mL/min的肾被丢弃更多（AOR分别为2.5和7.9）。在ECD肾中，泵肾不太可能发生DGF（AOR = 0.59，p < 0.0001），但不发生移植物衰竭（RR = 0.9，p = 0.27）。活检结果和机器灌注是ECD肾废弃的重要相关因素;与移植肾衰竭的相关性需要进一步研究。
We examined factors associated with expanded criteria donor (ECD) kidney discard. Scientific Registry of Transplant Recipients (SRTR)/Organ Procurement and Transplantation Network (OPTN) data were examined for donor factors using logistic regression to determine the adjusted odds ratio (AOR) of discard of kidneys recovered between October 1999 and June 2005. Logistic and Cox regression models were used to determine associations with delayed graft function (DGF) and graft failure. Of the 12 536 recovered ECD kidneys, 5139 (41%) were discarded. Both the performance of a biopsy (AOR = 1.21, p = 0.02) and the degree of glomerulosclerosis (GS) on biopsy were significantly associated with increased odds of discard. GS was not consistently associated with DGF or graft failure. The discard rate of pumped ECD kidneys was 29.7% versus 43.6% for unpumped (AOR = 0.52, p < 0.0001). Among pumped kidneys, those with resistances of 0.26-0.38 and > 0.38 mmHg/mL/min were discarded more than those with resistances of 0.18-0.25 mmHg/mL/min (AOR = 2.5 and 7.9, respectively). Among ECD kidneys, pumped kidneys were less likely to have DGF (AOR = 0.59, p < 0.0001) but not graft failure (RR = 0.9, p = 0.27). Biopsy findings and machine perfusion are important correlates of ECD kidney discard; corresponding associations with graft failure require further study.