Ann Surg Treat Res.  2015 Oct;89(4):208-214. 10.4174/astr.2015.89.4.208.

Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation

• Seo CH
• Ju JI
• Kim MH
• Jun KW
• Ahn SH
• Hwang JK
• Kim SD
• Park SC
• Choi BS
• Kim JI
• Yang CW
• Kim YS
• Moon IS

• KMID: 2166894
• DOI: http://doi.org/10.4174/astr.2015.89.4.208

Abstract

PURPOSE
The purpose of this study was to analyze the risk factors for delayed graft function (DGF) and determine its impact on the outcomes of deceased donor (DD) kidney transplantation (KT).
METHODS
Between January 2000 and December 2011, we performed 195 DD renal transplants. After the exclusion of primary nonfunctional grafts (n = 4), the study recipients were divided into two groups-group I, DGF (n = 31, 16.2%); group II, non-DGF (n = 160, 83.8%). The following variables were compared: donor and recipient characteristics, patient and graft survival, postoperative renal function, acute rejection (AR) episodes, and the rates of surgical and infectious complications.
RESULTS
Donor-related variables that showed significant differences included hypertension (P = 0.042), diabetes (P = 0.025), and prerecovery serum creatinine levels (P < 0.001). However, there were no significant differences in recipient-related factors. One significantly different transplant-related factor was positive panel reactive antibody (PRA > 20%, P = 0.008). On multivariate analysis, only the prerecovery serum creatinine level (P < 0.001; hazard ratio [HR], 1.814) was an independent risk factor for the development of DGF. A Cox multivariate analysis of risk factors for graft survival identified these independent risk factors for graft survival: nephron mass (donor kidney weight to recipient body weight ratio) index (P = 0.026; HR, 2.328), CMV infection (P = 0.038; HR, 0.114), and AR episode (P = 0.038; HR, 0.166).
CONCLUSION
In DD KT, an independent risk factor for DGF was the prerecovery serum creatinine level. Although there was a significant difference in graft survival between the DGF and non-DGF groups, DGF was not an independent risk factor for graft failure in this study.

Keyword

Delayed graft function; Deceased donor renal transplantation

MeSH Terms

Body Weight
Creatinine
Delayed Graft Function*
Graft Survival
Humans
Hypertension
Kidney
Kidney Transplantation*
Multivariate Analysis
Nephrons
Risk Factors*
Tissue Donors*
Transplants
Creatinine

Figure

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  Fig. 1 Graft (A, P = 0.020) and patient survival (B, P = 0.502) in both groups. DGF, delayed graft function.

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