Establishment Of Quality Evaluation Criteria And DGF Prediction Model Of DD Donor Kidney In Single Center

Objective: Delayed graft function(DGF)is an acute renal failure,which causes less urine after renal transplantation,increases the risk of immunogenicity and rejection of the transplanted kidney,and reduces the long-term survival rate of the transplanted kidney.At present,hemodialysis is needed at least once within 7 days after transplantation,or although it is not,the level of creatinine in the seventh day after operation is higher than 400umol/l as the diagnostic standard for delayed recovery of renal function.The risk factors related to delayed recovery of renal function after transplantation were determined by analyzing the clinical data of donor kidney and receptor after death of citizens.The quality evaluation standard of single center donor kidney was established,and the DGF prediction model was established based on the standard.Early prediction,early diagnosis and early intervention of DGF are helpful to evaluate the quality of donor kidney and the choice of treatment plan before and after operation.Methods: The clinical data of 108 DD donor kidneys and corresponding 198 renal transplant recipients from January 2018 to December 2018 in our center were retrospectively analyzed.Referring to the domestic and foreign literature reports,the donor age,primary disease,body mass index(BMI),history of diabetes and hypertension,serum creatinine value before donation,transient renal function injury before donation,the incidence rate of renal failure before donation,the incidence rate of renal failure before donation,the incidence rate of renal failure after donation were analyzed Univariate analysis was used to determine the risk factors for the application of vasopressor drugs in maintenance period.The identified risk factors were included in multivariate logistic regression analysis,and the single center donor kidney quality score standard and DGF prediction model were established.Results: Based on the clinical data of 108 donor kidneys and 198 recipients of kidney transplantation after the death of citizens,six risk factors including donor age,Primary disease,history of hypertension,serum creatinine level before donation,transient renal function injury before donation and application of Pressor drugs were established.On this basis,a scoring system for donor kidneys after the death of citizens was established They were divided into low-risk group(0-10 points),medium risk group(10-20 points),highrisk group(20-30 points)and super high-risk group(more than 30 points).There were 102 cases with renal score of 0-10 points,8 cases with delayed recovery of renal function after operation,and the incidence of DGF was 7.8%,52 cases with 10-20 points,including 6 cases with delayed recovery of renal function,11.5% with DGF,and 36 cases with 20-30 points,including 8 cases with delayed recovery of renal function,and 22.5% with DGF Among them,4 cases had delayed recovery of renal function,and the incidence of DGF was 50%.The incidence of delayed recovery of renal function in Patients with score greater than 20 was significantly higher than that in Patients with score less than 20(P = 0.022).Conclusion: The age,primary disease,history of hypertension,application of pressor drugs,transient renal function injury before donation and serum creatinine before donation of organ donors after death are closely related to the occurrence of delayed recovery of renal function after renal transplantation,which are the risk factors of DGF.The evaluation criteria of donor quality based on DGF risk factors analysis can effectively predict the occurrence probability of DGF after operation,and objectively evaluate the original quality of DD donor kidney.