Delayed Graft Function in Renal Transplant Recipients: Risk Factors and Impact on 1-Year Graft Function: A Single Center Analysis

• Published in: Transplantation proceedings 2009-04, Vol.41 (3), p.849-851
• Main Authors: Bronzatto, E.J.M, da Silva Quadros, K.R, Santos, R.L.S, Alves-Filho, G, Mazzali, M
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cadaver; Epidemiology; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; General aspects; Graft Survival - physiology; Humans; Ischemia; Kidney Diseases - classification; Kidney Diseases - surgery; Kidney Transplantation - pathology; Kidney Transplantation - physiology; Kidney Tubules - pathology; Length of Stay; Medical sciences; Middle Aged; Necrosis; Postoperative Complications - epidemiology; Postoperative Complications - pathology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Risk Factors; Sex Characteristics; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue Donors - statistics & numerical data; Tissue, organ and graft immunology; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2009.02.004

Abstract Delayed graft function (DGF), a frequent complication after kidney transplantation, occurs among about 60% of recipients of kidneys from deceased donors. DGF has a multifactorial etiology. It is characterized by acute tubular necrosis (ATN) upon biopsy. In this study we sought to identify among a group of recipients of kidneys from deceased donors, the incidence, risk factors, and impacts on patient and graft survivals of DGF. Materials and Methods We retrospectively analyzed medical records from renal transplant recipients aged >18 years who received a deceased donor kidney graft between January 2003 and December 2006. Kidneys lost during the first week posttransplantation were excluded from this series. Results Among 165 transplants, 111 (67%) displayed DGF, defined as the need for dialysis during the first week posttransplantation. The incidence of DGF was higher among patients with a cold ischemia time (CIT) > 24 hours: 85% vs 60%, DGF vs no DGF ( P < .05), as well as for grafts from older donors. After 1-year follow-up, the DGF group showed worse graft function (serum creatinine 1.6 ± 0.7 vs 1.3 ± 0.4 mg/dL; P < .05) as well as a greater incidence of graft loss. Conclusion Prolonged cold ischemia and older donor age were associated with a greater incidence of DGF in this series, leading to prolonged hospitalization, increased risk for an acute rejection episode, and reduced graft function and survival after 1 year.