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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

56
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

83
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

80
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Related Experiment Video

Updated: Sep 6, 2025

Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
08:12

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Delayed Graft Function Duration in Deceased Donor Kidney Transplants.

Flávia Carvalho Leão-Reis1, Bernardo Duarte Pessoa De Carvalho Silva1, Júlia Drumond Parreiras De Morais1

  • 1Transplantation/Nephrology Division, University Hospital of the Faculty of Medical Science, Belo Horizonte, Minas Gerais, Brazil.

Transplantation Proceedings
|June 29, 2022
PubMed
Summary

Delayed graft function (DGF) after kidney transplantation, especially when lasting over 8 days and linked to HLA mismatches, elevates acute rejection risk. However, DGF duration does not impact long-term patient or graft survival.

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Area of Science:

  • Nephrology
  • Transplantation immunology
  • Clinical outcomes research

Background:

  • Delayed graft function (DGF) is a key prognostic factor in kidney transplantation, with varying clinical presentations and recovery times.
  • The impact of DGF presence and duration on transplant outcomes is significant, yet a consistent definition for adverse outcomes is lacking.
  • Ischemia-reperfusion injury severity influences DGF presentation and renal function recovery post-transplant.

Purpose of the Study:

  • To determine the impact of delayed graft function (DGF) duration on patient and graft survival following deceased donor kidney transplantation.
  • To identify a specific cutoff point for DGF duration associated with worse clinical outcomes.
  • To investigate the relationship between DGF, HLA mismatches, acute rejection, and long-term survival.

Main Methods:

  • A single-center retrospective study analyzed 188 deceased donor kidney transplants from November 2008 to December 2015.
  • Receiver operating characteristic curve analysis identified the optimal cutoff for DGF duration predicting adverse outcomes.
  • Patients were stratified based on DGF duration: less than 8 days versus 8 days or more.

Main Results:

  • The incidence of DGF was 62.2% in the study cohort.
  • Increased HLA mismatches were identified as an independent risk factor for prolonged DGF.
  • DGF lasting 8 days or longer was significantly associated with acute rejection, which in turn correlated with patient death within 3 years.

Conclusions:

  • Delayed graft function exceeding 8 days, particularly with higher HLA mismatches, increases the risk of acute rejection.
  • Despite the association with acute rejection, DGF duration does not appear to affect overall graft loss or patient survival.
  • The findings suggest that while DGF impacts early post-transplant events like rejection, its long-term prognostic value for survival may be limited.