INTRODUCTION: Delayed graft function (DGF), a well-known immediate postoperative complication is defined as the need for dialysis during the first week after deceased donor kidney transplantation. It affects 25% to 50% of recipients. In this study we identified risk factors for DGF and its impact on patient and graft survivals. METHODS: We retrospectively analyzed medical records from renal transplant recipients aged above 18 years who received a deceased donor kidney graft between November 2008 and December 2011, excluding kidney losses during the first week. RESULTS: Among 137 transplantations, 64 (46.5%) displayed DGF. Multivariate analysis showed secondary renal disease (OR 3.7, CI 1.36-10.30; P = .011), HLA mismatches > 3 (OR 4.4, CI 1.53-12.51; P = .006) and donor urine output ≤ 3000 ml/24h (OR 25.8, CI 3.60-185.70; P = .001) to be significant risk factors for DGF. The hospitalization time was longer in the DGF group (38,2 ± 20,75 vs. 25,6 ± 8,18; P < .001). At 1 month, DGF group showed worse graft function based upon serum creatinine: 207.7 ± 148.52 vs 118.1 ± 36.63 μmol/L (P < .001). At 1 year follow-up, incidence of biopsy-proven acute renal rejection episodes was higher in the DGF (28; 51,9%) vs. the non-DGF group (18; 33,3%; P = .05). The 1-year recipient survival in DGF and no DGF groups were 90% vs 97% respectively (P = .124). With 1-year death censored graft survivals of 92% vs 100% respectively (P = .062). CONCLUSION: Secondary renal disease, HLA mismatches and lower donor urinary output were associated with a greater incidence of DGF, leading to prolonged hospitalizations and an increased risk for an acute rejection episode.
INTRODUCTION: Delayed graft function (DGF), a well-known immediate postoperative complication is defined as the need for dialysis during the first week after deceased donor kidney transplantation. It affects 25% to 50% of recipients. In this study we identified risk factors for DGF and its impact on patient and graft survivals. METHODS: We retrospectively analyzed medical records from renal transplant recipients aged above 18 years who received a deceased donor kidney graft between November 2008 and December 2011, excluding kidney losses during the first week. RESULTS: Among 137 transplantations, 64 (46.5%) displayed DGF. Multivariate analysis showed secondary renal disease (OR 3.7, CI 1.36-10.30; P = .011), HLA mismatches > 3 (OR 4.4, CI 1.53-12.51; P = .006) and donor urine output ≤ 3000 ml/24h (OR 25.8, CI 3.60-185.70; P = .001) to be significant risk factors for DGF. The hospitalization time was longer in the DGF group (38,2 ± 20,75 vs. 25,6 ± 8,18; P < .001). At 1 month, DGF group showed worse graft function based upon serum creatinine: 207.7 ± 148.52 vs 118.1 ± 36.63 μmol/L (P < .001). At 1 year follow-up, incidence of biopsy-proven acute renal rejection episodes was higher in the DGF (28; 51,9%) vs. the non-DGF group (18; 33,3%; P = .05). The 1-year recipient survival in DGF and no DGF groups were 90% vs 97% respectively (P = .124). With 1-year death censored graft survivals of 92% vs 100% respectively (P = .062). CONCLUSION: Secondary renal disease, HLA mismatches and lower donor urinary output were associated with a greater incidence of DGF, leading to prolonged hospitalizations and an increased risk for an acute rejection episode.
Authors: Islam M Korayem; Vatche G Agopian; Keri E Lunsford; Hans A Gritsch; Jeffrey L Veale; Gerald S Lipshutz; Hasan Yersiz; Coney L Serrone; Fady M Kaldas; Douglas G Farmer; Suphamai Bunnapradist; Gabriel M Danovitch; Ronald W Busuttil; Ali Zarrinpar Journal: Clin Transplant Date: 2019-05-07 Impact factor: 2.863
Authors: Nicoline V Krogstrup; Mihai Oltean; Bo M Bibby; Gertrude J Nieuwenhuijs-Moeke; Frank J M F Dor; Henrik Birn; Bente Jespersen Journal: BMJ Open Date: 2015-08-20 Impact factor: 2.692
Authors: Chang Ho Seo; Jeong Il Ju; Mi-Hyeong Kim; Kang Woong Jun; Sang-Hyun Ahn; Jeong Kye Hwang; Sang Dong Kim; Sun Cheol Park; Bum Soon Choi; Ji Il Kim; Chul Woo Yang; Yong Soo Kim; In Sung Moon Journal: Ann Surg Treat Res Date: 2015-09-25 Impact factor: 1.859
Authors: Marie B Nielsen; Nicoline V Krogstrup; Mihai Oltean; Gertrude J Nieuwenhuijs-Moeke; Frank J M F Dor; Henrik Birn; Bente Jespersen Journal: PLoS One Date: 2019-12-30 Impact factor: 3.240