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Risk Balancing of Cold Ischemic Time against Night Shift Surgery Possibly Reduces Rates of Reoperation and Perioperative Graft Loss
Joint Authors
Lehner, Frank
Klempnauer, Juergen
Schrem, Harald
Ringe, Bastian P.
Boeckler, Julius
Kaltenborn, Alexander
Koch, Hans Friedrich
Emmanouilidis, Nikos
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-16, 16 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-01-19
Country of Publication
Egypt
No. of Pages
16
Main Subjects
Abstract EN
Background.
This retrospective cohort study evaluates the advantages of risk balancing between prolonged cold ischemic time (CIT) and late night surgery.
Methods.
1262 deceased donor kidney transplantations were analyzed.
Multivariable regression was used to determine odds ratios (ORs) for reoperation, graft loss, delayed graft function (DGF), and discharge on dialysis.
CIT was categorized according to a forward stepwise pattern ≤1h/>1h, ≤2h/>2h, ≤3h/>3h,…, ≤nh/>nh.
ORs for DGF were plotted against CIT and a nonlinear regression function with best R2 was identified.
First and second derivative were then implemented into the curvature formula k(x)=f′′(x)/(1+f′x2)3/2 to determine the point of highest CIT-mediated risk acceleration.
Results.
Surgery between 3 AM and 6 AM is an independent risk factor for reoperation and graft loss, whereas prolonged CIT is only relevant for DGF.
CIT-mediated risk for DGF follows an exponential pattern fx=A·(1+k·eI·x) with a cut-off for the highest risk increment at 23.5 hours.
Conclusions.
The risk of surgery at 3 AM–6 AM outweighs prolonged CIT when confined within 23.5 hours as determined by a new mathematical approach to calculate turning points of nonlinear time related risks.
CIT is only relevant for the endpoint of DGF but had no impact on discharge on dialysis, reoperation, or graft loss.
American Psychological Association (APA)
Emmanouilidis, Nikos& Boeckler, Julius& Ringe, Bastian P.& Kaltenborn, Alexander& Lehner, Frank& Koch, Hans Friedrich…[et al.]. 2017. Risk Balancing of Cold Ischemic Time against Night Shift Surgery Possibly Reduces Rates of Reoperation and Perioperative Graft Loss. Journal of Transplantation،Vol. 2017, no. 2017, pp.1-16.
https://search.emarefa.net/detail/BIM-1187986
Modern Language Association (MLA)
Emmanouilidis, Nikos…[et al.]. Risk Balancing of Cold Ischemic Time against Night Shift Surgery Possibly Reduces Rates of Reoperation and Perioperative Graft Loss. Journal of Transplantation No. 2017 (2017), pp.1-16.
https://search.emarefa.net/detail/BIM-1187986
American Medical Association (AMA)
Emmanouilidis, Nikos& Boeckler, Julius& Ringe, Bastian P.& Kaltenborn, Alexander& Lehner, Frank& Koch, Hans Friedrich…[et al.]. Risk Balancing of Cold Ischemic Time against Night Shift Surgery Possibly Reduces Rates of Reoperation and Perioperative Graft Loss. Journal of Transplantation. 2017. Vol. 2017, no. 2017, pp.1-16.
https://search.emarefa.net/detail/BIM-1187986
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1187986