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

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.

• 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: Annals of surgical treatment and research (Ann Surg Treat Res) Vol. 89 Issue 4 Pg. 208-14 (Oct 2015) ISSN: 2288-6575 [Print] Korea (South)
• PMID: 26446498 (Publication Type: Journal Article)