Factors and prognosis analysis of graft renal function recovery after DCD donor renal transplantation

Objective To analyze the factors and prognosis of graft recovery after donation after citizens death (DCD) donor renal transplantation. Methods A retrospective analysis of 67 cases of DCD renal transplantation from August 2012 to September 2015 in our hospital was carried out. According to the stability of renal function after operation, the patients were divided into group A (51 cases) with stable renal function, and 16 cases in group B (delayed graft function after operation). The clinical data of two groups including age, gender, cause of death, warm ischemia time, type of dialysis, and application of norepinephrine before operation were collected and analyzed. The related factors of graft function recovery were analyzed. Logistic regression analysis was used to analyze the risk factors of graft functional recovery after operation. The 3-month, 6-month, 1-year and 18-month survival rate after operation in the two groups was compared. Results The causes of death, the time of ischemia, the type of dialysis before operation, the application of norepinephrine before operation, infants and young donors were related factors of graft function recovery (P<0.05). Logistic regression analysis showed that cerebral hemorrhage death donor, the long thermal ischemia time, the preoperative hemodialysis and the application of norepinephrine before operation were the risk factors of delayed graft function recovery (P<0.05). The 3-month, 6-month, 1-year and 18-month survival rate after operation in group A was higher than that in group B, with the difference being statistically significant (P<0.05). Conclusion Cerebral hemorrhage death donor, the long thermal ischemia time, the preoperative hemodialysis and the application of norepinephrine before operation were the independent risk factors of delayed graft function recovery. And the prognosis of patients with delayed graft function was poor. Clinical risk should be eliminated or reduced in clinical practice, which can effectively prevent the delayed graft function and further improve the prognosis of the patients. Key words: Graft function; Kiney transplantation; Warm ischemic time; Cardiac death; Survival rate