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2015, Number 1

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Rev cubana med 2015; 54 (1)

Creatinemia and long stay at hospital discharge in post renal transplant period. Causes and consequences on graft outcome

Borroto DG, Guerrero DC, Centeno CE

Language: Spanish
References: 46
Page: 40-57
PDF size: 338.51 Kb.


ABSTRACT

Introduction: a number of conditions and complications interact during period immediately after kidney transplantation, which affect a lengthy hospital stay and a suboptimal graft function at discharge, given this high serum creatinine.
Objective: relate the presence of some clinical complications and general nature variables with transplant function and during immediate postoperative stay.
Methods: observational, retrospective, longitudinal study was conducted at Hermanos Ameijeiras hospital, covering renal transplants performed from 1984 to January 1st, 2013, in subjects older than 15 years of age and who survived a year after. Combined transplants, third transplants or those whose all required information could not be obtained were excluded. Through a multivariate analysis, variables were considered such as age of the recipient and the donor, recipient sex, donor type, the underlying disease that caused the kidney failure, cold ischemic time and secondary warm ischemia time, the presence of acute tubular necrosis, rejection and cyclosporine A nephrotoxicity, hospital stay and creatinine values at discharge in the post- operative period. The possible influence of the latter two parameters was determined in graft survival by Kaplan and Meir.
Results: the oldest age of the donor and recipient, deceased donor, diabetes mellitus and polycystic kidney disease, the occurrence of acute tubular necrosis, rejection and cyclosporine nephrotoxicity conditioned longer admission and less graft function at discharge, which also influenced negatively the subsequent survival of renal transplant.
Conclusions: the highest values of creatinine at discharge and prolonged hospital stay in the immediate postoperative period of renal transplant formed the basis of complications, and long term negative impact parameters on graft survival.


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