The impact of meeting donor management goals on the development of delayed graft function in kidney transplant recipients

Darren Malinoski, M. S. Patel, O. Ahmed, M. C. Daly, S. Mooney, C. O. Graybill, C. E. Foster, A. Salim

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Many organ procurement organizations (OPOs) utilize preset critical care endpoints as donor management goals (DMGs) in order to standardize care and improve outcomes. The objective of this study was to determine the impact of meeting DMGs on delayed graft function (DGF) in renal transplant recipients. All eight OPOs of the United Network for Organ Sharing Region 5 prospectively implemented nine DMGs in every donor after neurologic determination of death (DNDD). "DMGs met" was defined a priori as achieving any seven of the nine DMGs and this was recorded at the time of consent for donation to reflect donor hospital ICU management, 12-18 h later, and prior to organ recovery. Multivariable analyses were performed to identify independent predictors of DGF (dialysis in the first week after transplantation) with a p <0.05. A total of 722 transplanted kidneys from 492 DNDDs were included. A total of 28% developed DGF. DMGs were met at consent in 14%, 12-18 h in 32% and prior to recovery in 38%. DGF was less common when DMGs were met at consent (17% vs. 30%, p = 0.007). Independent predictors of DGF were age, Cr and cold ischemia time, while meeting DMGs at consent was significantly protective. The management of potential organ donors prior to consent affects outcomes and should remain a priority in the intensive care unit.

Original languageEnglish (US)
Pages (from-to)993-1000
Number of pages8
JournalAmerican Journal of Transplantation
Volume13
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

Fingerprint

Delayed Graft Function
Tissue Donors
Kidney
Tissue and Organ Procurement
Transplant Recipients
Cold Ischemia
Critical Care
Nervous System
Intensive Care Units
Dialysis
Transplantation

Keywords

  • Catastrophic brain injury guidelines
  • critical care
  • delayed graft function

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

The impact of meeting donor management goals on the development of delayed graft function in kidney transplant recipients. / Malinoski, Darren; Patel, M. S.; Ahmed, O.; Daly, M. C.; Mooney, S.; Graybill, C. O.; Foster, C. E.; Salim, A.

In: American Journal of Transplantation, Vol. 13, No. 4, 04.2013, p. 993-1000.

Research output: Contribution to journalArticle

Malinoski, Darren ; Patel, M. S. ; Ahmed, O. ; Daly, M. C. ; Mooney, S. ; Graybill, C. O. ; Foster, C. E. ; Salim, A. / The impact of meeting donor management goals on the development of delayed graft function in kidney transplant recipients. In: American Journal of Transplantation. 2013 ; Vol. 13, No. 4. pp. 993-1000.
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