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dc.contributor.authorVilar, Enric
dc.contributor.authorVaragunam, Mira
dc.contributor.authorYaqoob, Muhammad M
dc.contributor.authorRaftery, Martin
dc.contributor.authorThuraisingham, Raj
dc.date.accessioned2017-09-11T16:40:08Z
dc.date.available2017-09-11T16:40:08Z
dc.date.issued2010-01-15
dc.identifier.citationVilar , E , Varagunam , M , Yaqoob , M M , Raftery , M & Thuraisingham , R 2010 , ' Creatinine reduction ratio : a useful marker to identify medium and high-risk renal transplants ' , Cell Transplantation , vol. 89 , no. 1 , pp. 97-103 . https://doi.org/10.1097/TP.0b013e3181be3dd1
dc.identifier.issn0963-6897
dc.identifier.otherPURE: 10604763
dc.identifier.otherPURE UUID: ff896945-1f3f-45c8-a7f0-329dc1a917c3
dc.identifier.otherPubMed: 20061925
dc.identifier.otherScopus: 74549153266
dc.identifier.urihttp://hdl.handle.net/2299/19331
dc.description.abstractINTRODUCTION: Delayed graft function (DGF) has a major impact on long-term renal transplant survival. However, it is a diagnosis made retrospectively with little opportunity to modify treatment protocols. A classification based on creatinine reduction ratio between days 1 and 2 (CRR2) suggests that patients with CRR2 less than or equal to 30% (nondialysis requiring DGF [ND-DGF]) have similar outcomes to those with dialysis-requiring delayed graft function (D-DGF). We retrospectively applied this definition in our cohort of patients to examine outcomes. METHODS: We studied the association between CRR2 and graft outcomes in all 367 patients transplanted between 1996 and 2004 at our center. Patients were divided into the following three groups: IGF (immediate graft function; CRR2 >30%), D-DGF, and ND-DGF. Mean follow-up was 4.2 years. RESULTS: IGF accounted for 36% of patients, D-DGF for 22%, and ND-DGF for 42%. CRR2 was inversely correlated with serum creatinine on days 7, 30, 90, and 365 (r ranging from -0.65 to -0.22, P<0.001). Graft survival at 5 years was 98% (IGF), 74% (D-DGF), and 89% (ND-DGF). There was a significant difference in graft survival between IGF and D-DGF (P<0.001) and IGF and ND-DGF (P=0.005). In a multivariate analysis adjusting for recipient age and sex, donor age and sex, and human leukocyte antigen mismatch, graft failure was 2.4 times more likely to occur in patients with D-DGF than those with ND-DGF(P=0.02). CONCLUSIONS: Our study shows CRR2 influences long-term graft outcomes. Unlike the original description, patients with ND-DGF carry an intermediate risk and perhaps should be considered on day 2 for alternative treatment protocols.en
dc.format.extent7
dc.language.isoeng
dc.relation.ispartofCell Transplantation
dc.subjectAdult
dc.subjectBiomarkers
dc.subjectCohort Studies
dc.subjectCreatinine
dc.subjectDelayed Graft Function
dc.subjectDrug Therapy, Combination
dc.subjectFemale
dc.subjectGraft Rejection
dc.subjectGraft Survival
dc.subjectHistocompatibility Testing
dc.subjectHumans
dc.subjectImmunosuppressive Agents
dc.subjectKidney Transplantation
dc.subjectLikelihood Functions
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMultivariate Analysis
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectRisk Reduction Behavior
dc.subjectSurvival Rate
dc.subjectSurvivors
dc.subjectTissue Donors
dc.subjectTreatment Failure
dc.titleCreatinine reduction ratio : a useful marker to identify medium and high-risk renal transplantsen
dc.contributor.institutionSchool of Life and Medical Sciences
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dcterms.dateAccepted2009-08-20
rioxxterms.versionofrecordhttps://doi.org/10.1097/TP.0b013e3181be3dd1
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeclosedAccess


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