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Delayed graft function and its management in children.
- Source :
-
Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2017 Jul; Vol. 32 (7), pp. 1157-1167. Date of Electronic Publication: 2016 Oct 24. - Publication Year :
- 2017
-
Abstract
- Delayed graft function (DGF) is commonly defined as the requirement for dialysis within the first 7 days following renal transplantation. The major underlying mechanism is related to ischaemia/reperfusion injury, which includes microvascular inflammation and cell death and apoptosis, and to the regeneration processes. Several clinical factors related to donor, recipient and organ procurement/transplantation procedures may increase the risk of DGF, including donor cardiovascular instability, older donor age, donor creatinine concentration, long cold ischaemia time and marked body mass index of both the donor and recipient. Some of these parameters have been used in specific predictive formulas created to assess the risk of DGF. A variety of other pre-, intra- and post-transplant clinical factors may also increase the risk of DGF, such as potential drug nephrotoxicity, surgical problems and/or hyperimmunization of the recipient. DGF may decrease the long-term graft function, but data on this effect are inconsistent, partially due to the many different types of organ donation. Relevant management strategies may be classified into the classic clinical approach, which has the aim of minimizing the individual risk factors of DGF, and specific pharmacologic strategies, which are designed to prevent or treat ischaemia/reperfusion injury. Both strategies are currently being evaluated in clinical trials.
- Subjects :
- Age Factors
Allografts drug effects
Body Mass Index
Child
Cold Ischemia adverse effects
Creatinine blood
Delayed Graft Function etiology
Graft Rejection etiology
Graft Survival drug effects
Humans
Kidney drug effects
Renal Dialysis instrumentation
Risk Factors
Time Factors
Tissue Donors
Tissue and Organ Procurement methods
Transplant Recipients
Transplantation, Homologous adverse effects
Treatment Outcome
Allografts physiopathology
Delayed Graft Function therapy
Kidney physiopathology
Kidney Transplantation adverse effects
Renal Dialysis methods
Reperfusion Injury complications
Tissue and Organ Harvesting adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1432-198X
- Volume :
- 32
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Pediatric nephrology (Berlin, Germany)
- Publication Type :
- Academic Journal
- Accession number :
- 27778091
- Full Text :
- https://doi.org/10.1007/s00467-016-3528-9