Blessing and a curse of outpatient management of delayed graft function

作     者：Justin W Blazel Jennifer A Turk Brenda L Muth Sandesh Parajuli 

作者机构：Division of NephrologyDepartment of Medicine University of Wisconsin School of Medicine and Public Health 

出 版 物：《World Journal of Transplantation》 (世界移植杂志)

年 卷 期：2019年第9卷第4期

页      面：58-61页

学科分类：10[医学] 

主　　题：Delayed graft function Kidney transplantation Immunosuppression Acute rejection Kidney donor profile index Kidney donor risk index Dialysis 

摘      要：Delayed graft function (DGF) is a common complication occurring most often after deceased donor kidney transplant with several donor characteristics as well as immunologic factors that lead to its development *** patients require dialysis and close kidney function monitoring until sufficient allograft function is *** has resulted in limited options for DGF management,either prolonged hospitalization until graft function improves to the point where dialysis is no longer needed or discharge back to their home dialysis unit with periodic follow up in the transplant *** is associated with a higher risk for acute rejection,premature graft failure,and 30-d readmission;therefore,these patients need close monitoring,immunosuppression management,and prompt allograft biopsy if prolonged DGF is *** may not occur if these patients are discharged back to their home dialysis *** address this issue,the University of Wisconsin-Madison created a clinic in 2011 specialized in outpatient DGF *** clinic was able to successfully reduce hospital length of stay without an increase in 30-d readmission,graft loss,and patient death.