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The influence of deceased kidney donor blood urea nitrogen (BUN) level on graft and patient survival time

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TitleInfo
Title
The influence of deceased kidney donor blood urea nitrogen (BUN) level on graft and patient survival time
Name (type = personal)
NamePart (type = family)
Alzayer
NamePart (type = given)
Maha A.
NamePart (type = date)
1983-
DisplayForm
Maha A. Alzayer
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Coffman
NamePart (type = given)
Frederick
DisplayForm
Frederick Coffman
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = personal)
NamePart (type = family)
Srinivasan
NamePart (type = given)
Shankar
DisplayForm
Shankar Srinivasan
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
co-chair
Name (type = personal)
NamePart (type = family)
Gohel
NamePart (type = given)
Suril
DisplayForm
Suril Gohel
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
co-chair
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Health Professions
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (qualifier = exact)
2017
DateOther (type = degree); (qualifier = exact)
2017-05
CopyrightDate (encoding = w3cdtf); (qualifier = exact)
2017
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Abstract (type = abstract)
Although the advancement of surgical techniques and immunosuppressive therapy has significantly improved the outcomes of kidney transplantation in patients with end stage renal disease (ESRD), post-transplantation outcomes remain a big challenge. Accordingly, the goal of this dissertation was to determine which variables might have the most critical impact on the graft and patient survival time. One such variable which seemed significant but not well studied was the Blood Urea Nitrogen (BUN) level of the donor. Therefore, using the United Network for Organ Sharing (UNOS) registry database (October 1987 to March 2016), a retrospective (longitudinal) cohort study was setup to examine the relationship between the BUN level of the deceased donor and the survival of the graft and the patient while controlling for certain other variables. The final sample consisted of 168,081 patients in the United States. Multivariate cox regression analysis revealed that high log BUN level of deceased donor remained an independent predictor of graft loss (hazard ratio [HR], 1.080; 95% hazard ratio confidence limits [CI], 1.032 - 1.131; P = 0.0009) and patient death (hazard ratio [HR], 1.063; 95% hazard ratio confidence limits [CI], 1.007 - 1.121; P = 0.0262) compared to low log BUN level of deceased donor. Significant findings from this study indicate that high log BUN level (> 2.79 mg/dl) of deceased donor is independently associated with decreased graft and patient survival time compared to low log BUN level of deceased donor. It is to be noted that White, Black and Hispanic donors races have significant differences at 5 year graft and patient survival time while donors of other races (Asian, American Indian/Alaska native, Native Hawaiian/other Pacific Islander, and multiracial) did not show a statistically significant influence on graft and patient survival due to genetic influences. These results can potentially contribute to a more efficient allocation of resources to donor sources with better outcome prospect.
Subject (authority = RUETD)
Topic
Biomedical Informatics
Subject (authority = ETD-LCSH)
Topic
Kidneys--Transplantation
Subject (authority = ETD-LCSH)
Topic
Chronic renal failure
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_8123
PhysicalDescription
Form (authority = gmd)
electronic resource
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
1 online resource (xii, 163 p. : ill.)
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = statement of responsibility)
by Maha A. Alzayer
RelatedItem (type = host)
TitleInfo
Title
School of Health Related Professions ETD Collection
Identifier (type = local)
rucore10007400001
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Identifier (type = doi)
doi:10.7282/T3NV9N1B
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Alzayer
GivenName
Maha
MiddleName
A.
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2017-04-25 17:36:33
AssociatedEntity
Name
Maha Alzayer
Role
Copyright holder
Affiliation
Rutgers University. School of Health Professions
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
RightsEvent
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2017-05-31
DateTime (encoding = w3cdtf); (qualifier = exact); (point = end)
2019-05-31
Type
Embargo
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after May 31st, 2019.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2017-04-25T17:34:58
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2017-04-25T17:34:58
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