Isquemia fría prolongada, factor para rechazo agudo del injerto en trasplante renal cadavérico / Prolonged cold ischemia: risk factor for acute rejection in renal grafting of cadaveric kidney transplantation
Cir. & cir
; 77(5): 381-384, sept.-oct. 2009. tab
Article
in Spanish
| LILACS
| ID: lil-566470
Responsible library:
BR1.1
RESUMEN
Introducción:
Es conocido que la exposición del injerto renal a tiempo prolongado de isquemia fría se asocia con rechazo agudo. Dado que no se encontró evidencia del tema en México, el objetivo de este estudio fue determinar el papel del tiempo de isquemia fría prolongado sobre el injerto en el trasplante renal cadavérico en población mexicana. Material ymétodos:
Estudio observacional, retrospectivo, transversal y analítico para el que se seleccionaron los expedientes de pacientes con trasplante renal entre julio de 1994 y junio de 2004. Se realizó análisis de diferentes variables para determinar su efecto sobre el rechazo agudo, entre ellas el tiempo prolongado de isquemia fría (≥ 12 horas).Resultados:
De los 425 transplantes realizados, 33 fueron de donador cadavérico; 10 pacientes tuvieron rechazo agudo. El tiempo prolongado de isquemia fría (OR = 8.4, IC = 1.5-44.2, p = 0.02) y la combinación azatioprina (AZA)-prednisona (PDN)- ciclosporina (CSA) (OR = 9.1, IC = 1.5-49.4, p = 0.02) fueron factores de riesgo para rechazo agudo. El uso de antiCD25 (OR = 0.6, IC = 0.009-0.37, p = 0.001) y la combinación mofetil micofenolato (MMF)-PDN-CSA (OR = 0.1, IC = 0.02-0.65, p = 0.02) fueron factores protectores de rechazo agudo.Conclusiones:
En una población mexicana, el tiempo de isquemia fría prolongado y la combinación AZA-PDN-CSA fueron factores de riesgo para rechazo agudo, mientras que el uso de antiCD25 y la combinación MMF-PDN-CSA fueron protectores para rechazo agudo en trasplantes renales de donadores cadavéricos.ABSTRACT
BACKGROUND:
Exposure of renal grafting to prolonged cold ischemia time (CIT) and the association with acute rejection (AR) are known. However, there is no evidence in Mexico about this topic. Thus, the objective of this study was to evaluate prolonged CIT as a risk factor for AR in renal grafting of cadaveric kidney transplantation in a Mexican population.METHODS:
A cross-sectional study was carried out. Clinical files of patients undergoing renal grafting using cadaveric kidneys were reviewed from July 1994-June 2004. Prolonged CIT (=12 h) as a risk factor for AR was evaluated. Other related variables were also examined.RESULTS:
From 425 kidney transplantations, only 33 cases were cadaveric. Ten patients had AR. Prolonged CIT (OR 8.4; CI 1.5-44.2, p = 0.02) and azathioprine (AZA)-prednisone (PDN)-cyclosporine (CSA) combination (OR 9.1; CI 1.5-49.4, p = 0.02) were risk factors for AR. Anti-CD25 use (OR 0.6; CI 0.009-0.37, p = 0.001) and mycofenolate mofetil (MMF)-PDN-CSA combination (OR 0.1; CI 0.02-0.65, p = 0.02) were protective factors for AR.CONCLUSIONS:
In a Mexican population, prolonged CIT and AZA-PDN-CSA combination were risk factors for AR. Meanwhile, anti- CD25 use and MMF-PDN-CSA combination were protective factors for AR in cadaveric kidney transplantations.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Kidney Transplantation
/
Tissue and Organ Harvesting
/
Cold Ischemia
/
Graft Rejection
/
Kidney
Type of study:
Etiology study
/
Observational study
/
Prevalence study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Humans
Country/Region as subject:
Mexico
Language:
Spanish
Journal:
Cir. & cir
Journal subject:
CIRURGIA GERAL
Year:
2009
Document type:
Article
Affiliation country:
Mexico
Institution/Affiliation country:
Instituto Mexicano del Seguro Social/MX
/
Secretaria de Salud/MX
/
Universidad de Colima/MX