Frailty and Delayed Graft Function in Kidney Transplant Recipients
Frailty and Delayed Graft Function in Kidney Transplant Recipients
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DOI：
10.1001/archsurg.2011.1229
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发表时间：
2012-02-01
影响因子：
--
通讯作者：
Segev, Dorry L.
中科院分区：
文献类型：
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作者：
Garonzik-Wang, Jacqueline M.;Govindan, Priyanka;Segev, Dorry L.
预测肾移植后结局的能力受到肾衰竭复杂生理性下降的限制，这是一个使用传统合并症评估难以捕获的潜在因素。虚弱表型是最近描述的对应激源的脆弱性增加的炎症状态，其由生理储备减少和多个生理系统的失调引起。基于炎症细胞因子和移植物功能障碍之间的假定联系，我们假设虚弱与移植物功能延迟有关。我们前瞻性地测量了2008年12月至2010年4月间183例肾移植受者的虚弱程度。采用改良Poisson回归分析虚弱和移植肾功能延迟恢复之间的独立相关性。术前虚弱与移植物功能延迟恢复的风险增加1.94倍独立相关（95%CI，1.13-3.36; P= 0.02）。对虚弱程度的评估可能为同种异体移植物功能障碍的病理生理学提供进一步的见解，并可能提高我们对肾移植受者术前风险分层的能力。《外科学》2012;147（2）：190-193
The ability to predict outcomes following a kidney transplant is limited by the complex physiologic decline of kidney failure, a latent factor that is difficult to capture using conventional comorbidity assessment. The frailty phenotype is a recently described inflammatory state of increased vulnerability to stressors resulting from decreased physiologic reserve and dysregulation of multiple physiologic systems. We hypothesized that frailty would be associated with delayed graft function, based on putative associations between inflammatory cytokines and graft dysfunction. We prospectively measured frailty in 183 kidney transplant recipients between December 2008 andApril 2010. Independent associations between frailty and delayed graft function were analyzed using modified Poisson regression. Preoperative frailty was independently associated with a 1.94-fold increased risk for delayed graft function (95% CI, 1.13-3.36; P=.02). The assessment of frailty may provide further insights into the pathophysiology of allograft dysfunction and may improve our ability to preoperatively risk-stratify kidney transplant recipients. Arch Surg. 2012;147(2):190-193