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Abstract: TH-PO820

Left Ventricular Diastolic Dysfunction by Echocardiography Is a New Predictor of Delayed Graft Function

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Huo, Linhui, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
  • Jiang, Hongli, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
Background

Diastolic dysfunction (DD) is a common complication among end-stage renal disease (ESRD) patients. The ratio of early transmitral flow velocity (E) to early diastolic velocity (e') of the mitral annulus (E/e') is related to left ventricular (LV) diastolic dysfunction (LVDD). Delayed graft function (DGF) is a detrimental complication after kidney transplantation (KT). It is unclear whether increased E/e' predisposes a recipient to DGF.

Methods

A total of 574 patients were enrolled in this retrospective study. Two-dimensional echocardiography and Doppler imaging were performed. Multivariate logistic regression analyses were performed to calculate the OR (95%CI) for DGF. Model 1 included variables with P<0.05 in the multivariate logistic regression analyses. Model 2 was adjusted for demographic data (age and sex) and operation data (warm ischemia time and cold ischemia time). Model 3 (reference model) includes all the variables in Model 2 except E/e'. Discrimination was assessed by AUCs. Model performance was also evaluated by continuous net reclassification index (cNRI) and integrated discrimination improvement (IDI).

Results

93 patients (16.25%) developed DGF. E/e' was higher in DGF patients(14.07±6.16 vs. 11.51±4.23, P<0.001). Per 1 unit E/e' increase (OR 1.16; 95%CI, 1.1-1.23) and higher E/e' categories (8≤E/e' ≤14 OR 6.51; 95%CI, 2.38-17.80; E/e' >14 OR 6.58; 95%CI, 2.39-17.97) were associated with DGF. After adjusting for other covariates, the relationship between E/e' and DGF remained significant (adjusted OR 1.13; 95%CI, 1.07-1.18). Compared with Model 3, Model 2 had better discrimination and reclassification (cNRI, 46.48%; 95% CI, 24.61%- 68.34%; IDI, 4.36%; 95% CI, 1.81%-6.91%).

Conclusion

Our study found that higher E/e' was an independent predictor of DGF. This may provide an important perspective on the management of waiting list patients. Our results recommend that clinicians should take measures to lower E/e' before transplantation to lower DGF risks.