To Investigate The Factors Influencing Delayed Recovery Of Kidney Function During Perioperative Period

Objective Successful kidney transplantation and the successful recovery of transplanted kidney function depend on many factors such as good donor condition,surgical technique,stable hemodynamics during anesthesia and so on.There are several factors that can affect the perfusion of kidney transplantation and lead to its variability.This study intends to assess the risk factors for perioperative delayed recovery of graft function in patients with renal transplantation.Methods Retrospectively analyzed the clinical diagnosis and treatment data of organ donors and kidney transplant patients in the center’s urology department from january 2015 to october 2019,collected independent variable donor age,donor cold ischemia,donor kidney preservation mode,donor kidney terminal creatinine,dialysis program and time,anesthesia regimen,open blood pressure,fluid therapy regimen,HLA coordination point,immune induction regimen.the dependent variables were DGF or IGF of kidney function recovery in the recipient after kidney transplantation.Univariate and multivariate logistic regression analysis was performed.To investigate the risk factors of delayed recovery of kidney function.Results DGF occurred in 32 of 286 renal transplant recipients,or 11.2% of the total.univariate analysis was performed,in which age ≥60 years old,cold ischemia time ≥10 h,blood pressure <140/90 mm Hg,end creatinine level ≥122 umol/L,anesthesia regimen,fluid therapy regimen,postoperative analgesia,traditional cold preservation nine factors P <0.05,the difference was statistically significant.Dialysis program and time,anesthetic regimen,HLA miscoordination point,immune induction regimen,etc.,were not statistically significant.Multivariate logistic regression analysis,ischemia time ≥10h,blood pressure <140/90 mm Hg,terminal creatinine level ≥122umol/L,traditional cold preservation,anesthesia regimen,fluid therapy regimen,postoperative analgesia,etc.,the difference was statistically significant and was a risk factor for the occurrence of DGF.Conclusions High age of the donor,prolonged cold ischemia,elevated end creatinine levels and general anesthesia combined with epidural anesthesia were the risk factors for the occurrence of DGF;low temperature mechanical perfusion,appropriate hypertension and loose fluid therapy were the protective factors for DGF.Joint anesthesia regimen,dialysis duration,HLA miscoordination point,and immune induction regimen had no significant effect on the occurrence of DGF,which needed further prospective study.