Analysis on Risk Factors for Development of Delayed Graft Function in Living Donor Renal Transplantation

Ha, Mi Kyung; Kwon, Oh Jung; Lee, Kwang Soo; Kwak, Jin Young

Abstract

PURPOSE: Delayed graft function (DGF) is defined as the need for dialysis during the first week after renal transplantation, regardless of urine output. The aim of this study is to determine the incidence and possible etiologic factors of delayed graft function and its impact on outcome in living donor kidney transplantation.
METHODS
We selected 93 cases, which could be followed up, of living donor kidney transplantation from January 1, 1993 to June 30, 1995 at Transplantation center in Hanyang University Hospital. We analyzed multiple independent variables for DGF and graft survival such as donor and recipient age, donor and recipient sex, recipient/donor body weight ratio, the duration of dialysis before transplantation, HLA mismatch and cold ischemic time.
RESULTS
The incidence of DGF was 18.3% in overall. The overall 5 year graft survival rate was 92.3%, 73.3% in DGF group and 96.8% in immediate function group. We suggested that recipient/donor body weight ratio (> or = 1.2 vs. <1.2) had statistical significance as etiologic factor (P<0.05). The creatinine level of 30th postoperative day was 3.44 mg/dL in DGF group, and 1.59 mg/dL in immediate graft function group (P=0.016). DGF combined with acute rejection (AR) had more heavy negative impact on outcome of transplants than DGF alone.
CONCLUSION
The incidence of DGF was higher in recipient/donor body weight ratio > or =1.2 group than in <1.2 group. It may be due to relatively smaller nephron mass. The graft function was poor when DGF combined to AR, we suggested that recipient/donor body weight ratio might be considered in donor selection in living donor kidney transplantation, to lower the incidence of DGF.