Meta-analysis Of Risk Factors For Delayed Graft Function After Kidney Transplantation From Deceased Donor

ObjectiveKidney transplantation is the most effective treatment for end-stage renal disease at this stage.Delayed graft function(DGF)of transplanted kidney after organ transplantation is a common early complication.This study aims to explore partial donation after DD(Deceased donor)related risk factors of early occurrence of DGF after kidney transplantation,and then improve the understanding of the early postoperative complications,in order to provide certain guidance for clinical work.MethodsSearch electronic databases: PubMed,Embase,Cochrane Library,CBM,CNKI,VIP,Wanfang,search method: subject words plus free words,the time is to build the database until June 2020.Collect relevant literature,screen literature,and extract data.At this time,we need to use Rev Man5.3 software to fully evaluate the heterogeneity between the studies.On this basis,choose fixed effects models or random effects models,and then Meta-analyze.ResultsAfter comprehensively searching the literature,we obtained 1671 articles in foreign language database,including PubMed 461 articles,Embase 1096 articles,114 articles in the Cochrane Library,and 370 Chinese database articles including 58 articles in CNKI,202 articles in Wanfang,and 49 articles in VIP.Articles,61 articles of CBM,2041 articles in total were retrieved.After rigorous screening,19 domestic and foreign studies were finally included,with a total of 47,501 cases in the case group(DGF group)and 24,518 cases in the control group(non-DGF group).The DGF-related risk factors involved in this study included a total of 10 items,and a Meta-analysis was carried out.The results showed that the age of the recipients in the case group is higher than that of the control group(P=0.04),the body mass index(BMI)of the recipients in the case group is higher than the control group(P=0.004),and the male recipients are more likely to develop DGF.High(P<0.00001),the number of mismatches of human leukocyte antigen(HLA)in the case group was more than that in the control group(P=0.42),and the recipients who underwent multiple transplants were more likely to develop DGF(P=0.0001),the course of dialysis in the case group is relatively longer(P<0.00001),the age of the donor in the case group is higher than that in the control group(P<0.00001),and the body mass index(BMI)of the donor in the case group is higher than that in the control group(P<0.00001)The end-stage blood creatinine level of donors in the case group was higher than that in the control group(P<0.0001),and the cold ischemia time(CIT)in the case group was relatively longer(P=0.004).ConclusionElderly recipients,recipients with high BMI,male recipients,recipients with multiple transplants,recipients with long duration of dialysis,elderly donors,donors with high BMI,donor end-stage blood creatinine levels,and CIT prolonged are risk factors of DGF after kidney transplantation;the correlation between the number of HLA mismatches and the occurrence of postoperative DGF needs further research;further studies are still needed to conduct in-depth analysis of the factors related to postoperative DGF in multicenter,large sample,and prospective studies.