World journal of nephrology · 2026
Clinical outcomes of deceased donor kidney transplantation: Eight years of experience from a tertiary care center in India.
СтатьяНазвание и аннотация: Перевод в очереди
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Pahuja Taruna, Sangha Sukhwinder S, Yadav Sushma, Aggarwal Arnav, Bansal Virinder K, Vuthaluru Seenu, Aggarwal Sandeep, Subbiah Arun K, Vij Aarti, Agarwal Sanjay K, Bhowmik Dipankar, Yadav Pearl, Yadav Raj K
Аннотация
BACKGROUND: Deceased donor kidney transplantation (DDKT) remains underutilized in India due to organ shortage. Understanding determinants of transplant outcomes such as delayed graft function (DGF), graft survival and patient survival is essential to optimize patients and wisely allocate organs to best deserving patients.
AIM: To identify donor, recipient and peri-transplant determinants of DGF, graft and patient survival in DDKT.
METHODS: This is an ambispective cohort study for patients transplanted between January 2017 and September 2024. Primary outcome was incidence of DGF and predicting factors. Secondary outcomes were graft and patient survival. Logistic regression was used to analyse predicting factors for DGF and cox proportional hazards model was used to assess factors for graft and patient survival.
RESULTS: Among 62 DDKT, DGF occurred in 35.5% of DDKT recipients. While 6 factors affected DGF, only high recipient body mass index and high donor terminal serum creatinine were independent predictors of DGF. Over a median follow up of 32 months, 4 patients returned to maintenance haemodialysis and 11 patients died with functioning grafts with most events occurring within first year of transplant. Graft survival was 85.2% at 1 year and 68.2% at 4 years, while patient survival was 90.2% and 75.5%, respectively. Recipient age and kidney donor risk index (KDRI) were associated with graft loss. No factor affected mortality.
CONCLUSION: These findings highlight the importance of comprehensive donor and recipient assessment along with using KDRI or a new prediction tool for organ allocation in India. Larger multicentric studies from India are needed to further refine risk prediction models in DDKT.
AIM: To identify donor, recipient and peri-transplant determinants of DGF, graft and patient survival in DDKT.
METHODS: This is an ambispective cohort study for patients transplanted between January 2017 and September 2024. Primary outcome was incidence of DGF and predicting factors. Secondary outcomes were graft and patient survival. Logistic regression was used to analyse predicting factors for DGF and cox proportional hazards model was used to assess factors for graft and patient survival.
RESULTS: Among 62 DDKT, DGF occurred in 35.5% of DDKT recipients. While 6 factors affected DGF, only high recipient body mass index and high donor terminal serum creatinine were independent predictors of DGF. Over a median follow up of 32 months, 4 patients returned to maintenance haemodialysis and 11 patients died with functioning grafts with most events occurring within first year of transplant. Graft survival was 85.2% at 1 year and 68.2% at 4 years, while patient survival was 90.2% and 75.5%, respectively. Recipient age and kidney donor risk index (KDRI) were associated with graft loss. No factor affected mortality.
CONCLUSION: These findings highlight the importance of comprehensive donor and recipient assessment along with using KDRI or a new prediction tool for organ allocation in India. Larger multicentric studies from India are needed to further refine risk prediction models in DDKT.