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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"

"Objektif: untuk mengetahui apakah produksi urin awal pada hari pertama memiliki korelasi secara signifikan terhadap kejadian delayed graft function(DGF) dan dapat menjadi faktor prediktor terjadinya DGF.Metode: Penelitian ini membandingkan kejadian dari DGF dengan produksi urin awal yang dilaporkan studi, diambil dari database secara elektronik pada Medline, Cochrane dan EBSCO. Data akan diolah secara bivariat dan multivariat dan melihatkan sensitivitas dan spesifisitas berdasarkan hasil penelitian.Hasil: Total 179 penelitian didapatkan dari pencarian data. Dan 2 penelitian didapatkan dari sumber yang lain. Dari 1721 penelitian, 9 penelitian di ambil. Dan terdapat 5 penelitian yang memiliki sensitivitas dan spesifisitas penelitian. Secara umum, 9 penelitian ini memiliki tingkat bias yang rendah hingga sedang. Hampir seluruh penelitian melaporkan adanya hubungan yang signifikan antara produksi urin pada hari pertama dengan kejadian DGF. Dan seluruh penelitian setuju bahwa produksi urin awal merupakan prediktor yang sensitif untuk memprediksi DGF. Untuk spesifisitas memiliki nilai yang berbeda dari masing-masing penelitian. Perbedaan penggunaan batas yang optimal pada masing-masing penelitian merupakan penyebab adanya perbedaan variable atau hasil terkait spesifisitas.Kesimpulan: Produksi urin awal memiliki hubungan yang signifikan terkait kejadian DGFdan merupakan parameter yang baik digunakan untuk memprediksi kejadian DGF.

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Objective : This study aimed to discover whether the UOP1 correlates significantly to the DGF incidence and can be a DGF predicting factor.

Methods: This study compared the incidence of DGF with the UOP1 reported by studies obtained from the electronic databases, namely MEDLINE, Cochrane, and EBSCO. Studies that performed multivariate or bivariate analysis and/or reported sensitivity and specificity were included in this review..

Results: A total of 1719 studies were obtained from the database search, and 2 studies were enrolled from other sources. Out of 1721 studies, 9 studies were recruited in this review, 5 of which reported sensitivity and specificity. Overall, nine of these studies had a low to moderate risk of bias. Almost all studies reported a significant relationship between the UOP1 and DGF. All studies agreed that the UOP1 is a sensitive predictive factor in predicting DGF. The specificity reported by the studies examined in this review varied greatly. The use of optimum cut-off in each study is considered to be the cause of this variability.

Conclusion: The UOP1 is significantly related to the incidence of DGF and is a proper parameter for the prediction of DGF events."

"ABSTRACTPada pasien penyakit ginjal tahap akhir, transplantasi ginjal merupakan pilihan terbaik bagi pasien; akan tetapi, delayed graft function dapat menjadi komplikasi bagi pasien yang dapat berkembang menjadi rejeksi (penolakan) terhadap organ donor, sehingga menggagalkan transplantasi. Tujuan: Mengetahui hubungan antara faktor intraoperatif (warm ischemia time 1, cold ischemia time, warm ischemia time 2, waktu urin keluar, dan kompleksitas pembuluh darah) dan kejadian delayed graft function pada resipien. Metode: Peneliti melakukan studi potong-lintang dengan mengambil 611 data rekam medis pasien dari data rekapitulasi transplantasi ginjal di Departemen Urologi, Rumah Sakit Cipto Mangunkusumo, dari rentang waktu November 2011-September 2018. Peneliti kemudian melakukan analisis bivariat dan multivariat untuk menentukan signifikansi hubungan variabel. Hasil: Dari lima variabel yang diteliti, tidak terdapat satu pun variabel yang memiliki hubungan signifikan (p = 0,996; p = 0,125; p = 0,677; p = 0,332; p = 0,748; secara berurutan) dengan kejadian delayed graft function, dari total 545 pasien yang diteliti. Diskusi: Hubungan variabel yang tidak signifikan dapat dijelaskan oleh jenis donor pada penelitian ini yang sepenuhnya donor hidup, sehingga meminimalkan dampak buruk dari stress iskemik dan reperfusion injury yang disebabkan oleh faktor intraoperatif.

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ABSTRACTFor patients with end-stage renal disease, transplantation is the best option for renal replacement therapy; however, Delayed Graft Function can complicates the transplantation, and even progresses into organ rejection, resulting in a failed transplantation. Objective: The purpose of this study was to determine the association between intraoperative factors (warm ischemia time 1, cold ischemia time, warm ischemia time 2, time of first urine output, and blood vessels complexity) and delayed graft function in transplant recipient. Methods: Researcher used cross-sectional study design by collecting 611 patient data of medical record from data recapitulation of renal transplant by Departemen of Urology, Cipto Mangunkusumo National Referral Hospital, from November 2011-September 2018. Selected patient data were then analyzed using bivariate and multivariate analysis. Results: From five variables in this study, none of them have significant association (p = 0,996; p = 0,125; p = 0,677; p = 0,332; p = 748; respectively) with delayed graft function, from a total of 545 patients. Discussion: The insignificant association of variables may be explained by the type of donor in this study, that is compromised entirely of living donor, which reduce the negative impact of ischemic stress and reperfusion injury caused by the intraoperative factors."