Mortality Risk Linked to DGF Duration by ProQuest


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									                                                                                              JUNE 2010    Renal & Urology News 15

   ■ ATC, San Diego      Reports from the 2010 American Transplant Congress. Renal & Urology News editor Jody A. Charnow provided news coverage.

Mortality Risk Linked to DGF Duration                                                                                                 NODAT
The longer graft function is delayed, the greater the risk of death                                                                   Linked to Low
THE DURATION of delayed graft
function (DGF) affect mortality risk
                                             dard criteria donor kidneys; 50.6%
                                             of those who received donation
among renal transplant recipients            after cardiac death (DCD) donor                                                          RAPID NEW-ONSET diabetes after
surviving 90 days after transplantation,     kidneys; and 34.4% of subjects who                                                       transplantation (NODAT) may be more
a study found.                               received expanded criteria donor                                                         likely to occur in renal transplant
  Each added day of DGF is associ-           (ECD) kidneys.                                                                           recipients who experience hypomag-
ated with a 2% increased risk of death,        Patients who received DCD kidneys a
                                                                                                                                      nesemia in the first three months after
researchers reported. In addition, each      3.56 times significantly increased odds
                                                                                                                                      surgery, according to researchers.
added day of DGF is associated with          of having DGF. Recipients who had
                                                                                                                                        The finding emerged from a study
a 4% increased risk of acute rejec-          coronary artery disease had a significant
tion within six months following             81% increased odds. Each one-year                                                        of 16 renal transplant recipients
transplantation. It is possible that the     increment in donor age was associated                                                    conducted by researchers at North
impact of duration of DGF on patient         with a 2% increased odds.                                                                Shore-Long Island Jewish Health
death may be mediated through the              Among subjects with DGF, having                                                        Systems and Hofstra Medical School
effects of acute rejection, the investiga-   a DCD kidney was associated with a                                                       in Manhasset, N.Y. All patients were
tors stated.                                 significant twofold increased likelihood                                                  on a triple drug protocol consisting of
  The study, led by transplant neph-         of having an additional day of DGF.        Deepa Jayaram, MD
                                                                                                                                      mycophenolate sodium, tacrolimus,
rology fellow Deepa Jayaram, MD,             Each one-year increment in recipient                                                     and prednisone.
of the University of Michigan in             age at transplant was associated with a    kidneys to older recipients, Dr. Jayaram
                                                                                                                                        NODAT developed in three patients
Ann Arbor, included 683 renal trans-         significant 2% increased odds of having     said. The findings also support the need
                                                                                                                                      within the first three months post-
plant recipients, of whom 180 (26.4%)        an additional day of DGF.                  for efforts to reduce the duration of
had DGF. The mean and median dura-             Knowledge of the factors that influ-      DGF and the need for early diagnosis          transplant. These patients had a
tion of DGF was 11.9 and five days,           ence the risk and duration of DGF          and treatment of acute rejection in           mean hemoglobin A1c (HbA1c ) level
respectively. DGF occurred in 21.4%          could be of prognostic value particu-      patients with DGF in an attempt to            of 8.1; the remaining 13 patients
of the 513 patients who received stan-       larly in the allocation of ECD and DCD     improve clinical outcomes. ■                  (controls) had an HbA1c of 5.1.
                                                                                                                                      At three months, blood magne-
                                                                                                                                      sium levels were 1.3 mg/dL in

Low-Dose Fluconazole Prophylaxis Safe                                                                                             
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