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"[ABSTRAK LatarBelakangDelayedgraftfunction(DGF)adalahkomplikasiyangumumdijumpaipadatransplantasidarimayat.Berdasarkanstuditerdahulu,DGFdanfactorresikonyamemilikihasilyangbervariasipadadonornefrektomihidupMetodePenelitimelakukananalisisretrospektifdarirekammedicdonordanresipientransplantasiginjalpada100kasuslaparoskopidonornefrektomihidupdiRumahSakitCiptoMangunkusumodariNovember2011hinggaFebruari2014.KriteriaDGFadalahpasiendidialisispada1minggupostoperasidan/ataukreatininlebihdari2.5mg/dlpadaharike7postoperasi.PasienyangtidakmasukdalamkriteriatersebutdidefinisikanmemilikirenalallograftyangberfungsinormalHasilPrevalensiDGFpadapenelitianiniadalah14%.Indeksmassatubuhresipien,coldischemiatime,waktuanastomosisvaskular,dantotalischemiatimelebihtinggipadagrupDGF,tetapitidakditemukanfaktorresikoDGFyangsignifikansecarastatisticsaatdilakukananalisismultivariatKesimpulanInsidensiDGFpadastudiinimasukdalamrentangyangdiamatipadastudi-­‐studisebelumnya.FaktorresikoyangdilaporkansebagaifaktorresikoDGFpadalaparoskopidonornefrektomihiduptidaksignifikansecarastatistikdenganDGFpadastudikaliini.

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ABSTRACTBackgroundDelayed graft function (DGF) is a common complication affecting deceaseddonor renal transplantation. Based on previous studies, DGF and its risk factors inlive donor nephrectomy (LDN) have a various results.MethodsWe retrospectively analyzed the medical records of donor and recipient from ourfirst 100 cases of laparoscopic LDN in Cipto Mangunkusumo Hospital fromNovember 2011 to February 2014. The criteria used to define DGF were therequirement for dialysis in postoperative week 1 and/or serum creatinine greaterthan 2.5 mg/dl at postoperative day 7. Patients who did not match any of thesecriteria were define as having normal renal allograft function.ResultsThe overall prevalence of DGF was 14%. Recipients body mass index, coldischemia time, vascular anastomosis time, and total ischemia time were higheramong the delayed graft function group, but no risk factors for DGF weresignificantly associated after multivariate analysis.ConclusionsThe incidence of DGF in our study was in the range of that observed in previousstudies. The factors that previously reported and believed as risk factors of DGFin laparoscopic LDN were not significantly associated with the development ofDGF in our study.;BackgroundDelayed graft function (DGF) is a common complication affecting deceaseddonor renal transplantation. Based on previous studies, DGF and its risk factors inlive donor nephrectomy (LDN) have a various results.MethodsWe retrospectively analyzed the medical records of donor and recipient from ourfirst 100 cases of laparoscopic LDN in Cipto Mangunkusumo Hospital fromNovember 2011 to February 2014. The criteria used to define DGF were therequirement for dialysis in postoperative week 1 and/or serum creatinine greaterthan 2.5 mg/dl at postoperative day 7. Patients who did not match any of thesecriteria were define as having normal renal allograft function.ResultsThe overall prevalence of DGF was 14%. Recipients body mass index, coldischemia time, vascular anastomosis time, and total ischemia time were higheramong the delayed graft function group, but no risk factors for DGF weresignificantly associated after multivariate analysis.ConclusionsThe incidence of DGF in our study was in the range of that observed in previousstudies. The factors that previously reported and believed as risk factors of DGFin laparoscopic LDN were not significantly associated with the development ofDGF in our study.;BackgroundDelayed graft function (DGF) is a common complication affecting deceaseddonor renal transplantation. Based on previous studies, DGF and its risk factors inlive donor nephrectomy (LDN) have a various results.MethodsWe retrospectively analyzed the medical records of donor and recipient from ourfirst 100 cases of laparoscopic LDN in Cipto Mangunkusumo Hospital fromNovember 2011 to February 2014. The criteria used to define DGF were therequirement for dialysis in postoperative week 1 and/or serum creatinine greaterthan 2.5 mg/dl at postoperative day 7. Patients who did not match any of thesecriteria were define as having normal renal allograft function.ResultsThe overall prevalence of DGF was 14%. Recipients body mass index, coldischemia time, vascular anastomosis time, and total ischemia time were higheramong the delayed graft function group, but no risk factors for DGF weresignificantly associated after multivariate analysis.ConclusionsThe incidence of DGF in our study was in the range of that observed in previousstudies. The factors that previously reported and believed as risk factors of DGFin laparoscopic LDN were not significantly associated with the development ofDGF in our study., BackgroundDelayed graft function (DGF) is a common complication affecting deceaseddonor renal transplantation. Based on previous studies, DGF and its risk factors inlive donor nephrectomy (LDN) have a various results.MethodsWe retrospectively analyzed the medical records of donor and recipient from ourfirst 100 cases of laparoscopic LDN in Cipto Mangunkusumo Hospital fromNovember 2011 to February 2014. The criteria used to define DGF were therequirement for dialysis in postoperative week 1 and/or serum creatinine greaterthan 2.5 mg/dl at postoperative day 7. Patients who did not match any of thesecriteria were define as having normal renal allograft function.ResultsThe overall prevalence of DGF was 14%. Recipients body mass index, coldischemia time, vascular anastomosis time, and total ischemia time were higheramong the delayed graft function group, but no risk factors for DGF weresignificantly associated after multivariate analysis.ConclusionsThe incidence of DGF in our study was in the range of that observed in previousstudies. The factors that previously reported and believed as risk factors of DGFin laparoscopic LDN were not significantly associated with the development ofDGF in our study.]"

"Background: resistive index (RI) is highly utilised to assess the graft function using Doppler ultrasonography. The RI has been shown as the best ultrasound parameter to assess kidney allograft dysfunction. Several studies have established the role of the RI as a predictor of transplant failure. However, these studies were using RI measurement in the later stages post transplantation. The present study has conducted to identify the association between early RI measurement and early graft function represented as delayed graft function (DGF) and immediate graft function (IGF), as well as long-term graft survival. Methods: an evidence based clinical review of studies published before May 2018 was conducted from Medline, Science Direct, EMBASE and Cochrane databases. Studies on early measurement of RI whereby the primary or secondary goals of the study related to graft function and/or graft survival were included. Studies using late RI measurement and without RI value groups were excluded. The Mantzel Haenzel method was used to analyse pooled risk ratio and 95% confidence interval, while the heterogeneity of the study was calculated through I2 value. Data analysis was performed using Review Manager 5.3. Results: nine studies with a total of 1802 patients who had undergone a kidney transplant were analysed. DGF was found in 19% (193/1015) of the low RI group and in 42.8% (337/787) of the high RI group (RR 2.04 (95% CI 1.72 - 2.41), p < 0.00001, I2 = 28%). IGF was found in 39.5% (62/157) of the low RI group and in 10.5% (28/268) of the high RI group (RR 0.26 (95% CI 0.17 0.40), p < 0.00001, I2 = 0%). Long term graft survival, with follow up between 60 144 months, was found in 83% (701/845) of the low RI group and in 69.4% (395/569) of the high RI group (RR 0.82 (95% CI 0.72 0.93), p = 0.002, I2 = 63%). Conclusion: the results of this study emphasise the association between early measurement of RI and early graft function, and longterm graft survival. An elevated RI provides the chance of recognizing the patients with poor longterm prognosis, from the first moment after kidney transplant.

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Latar belakang: pemeriksaan Resistive Index (RI) sering dilakukan untuk menilai fungsi organ transplant dengan menggunakan alat Doppler ultrasonography. Hasil pemeriksaan RI merupakan parameter terbaik untuk menilai disfungsi ginjal transplant. Beberapa studi telah menunjukkan peran RI sebagai prediktor kegagalan transplantasi namun studi-studi tersebut menggunakan hasil RI yang tidak segera pasca transplantasi. Tujuan studi ini untuk mengidentifikasi hubungan antara hasil pemeriksaan RI yang dilakukan segera pasca transplantasi dengan fungsi awal ginjal transplant yang direpresentasikan oleh delayed graft function (DGF) dan immediate graft function (IGF) beserta angka kelangsungan hidup ginjal transplant dalam jangka waktu lama.

Metode:artikel yang merupakan tinjauan klinis berbasis bukti dilakukan pada penelitian yang dipublikasikan sebelum Mei 2018 menggunakan sumber dari Medline, Science Direct, EMBASE dan Cochrane. Penelitian yang mengukur hasil RI segera pasca transplantasi dimana tujuan utama atau tujuan sekundernya berkaitan dengan fungsi ginjal transplant dan/atau angka kelangsungan hidup ginjal transplant dimasukkan ke dalam studi ini. Penelitian yang mengukur hasil RI tidak segera pasca transplantasi dan tanpa kelompok tingkat RI, tidak dimasukkan ke dalam studi ini. Metode Mantzel-Haenzel digunakan untuk menganalisis pooled risk ratio dan 95% interval kepercayaan, sementara heterogenitas dianalisis melalui tingkat I2. Analisis menggunakan program Review Manager 5.3.

Hasil:analisis dilakukan pada sembilan penelitian dengan total pasien sebanyak 1802 pasca transplantasi ginjal. DGF ditemukan pada 19% (193/1015) pasien di kelompok RI rendah dan 42.8% (337/787) pasien di kelompok RI tinggi (RR 2.04 (95% IK 1.72-2.41), p < 0.00001, I2 = 28%). IGF ditemukan pada 39.5% (62/157) pasien di kelompok RI rendah dan 10.5% (28/268) pasien di kelompok RI tinggi (RR 0.26 (95% IK 0.17-0.40), p < 0.00001, I2 = 0%). Ginjal transplant yang masih berfungsi ditemukan pada 83% (701/845) pasien di grup RI rendah dan 69.4% (395/569) pasien di grup RI tinggi (RR 0.82 (95% IK 0.72-0.93), p = 0.002, I2 = 63%), dengan follow-up antara 60-144 bulan.

Kesimpulan: hasil studi ini menegaskan hubungan antara hasil pemeriksaan RI yang dilakukan segera pasca transplantasi dengan fungsi awal ginjal transplant dan kelangsungan hidup ginjal transplant dalam jangka waktu lama. Peningkatan RI memberikan peluang untuk mengenali pasien dengan prognosis jangka panjang yang buruk, bahkan disaat-saat awal pasca transplantasi ginjal"