title: Reduced graft function (with or without dialysis) vs immediate graft function--a comparison of long-term renal allograft survival.
abstract: BACKGROUND
  Delayed graft function (DGF) is a common complication in cadaveric kidney transplants affecting graft outcome. However, the incidence of DGF differs widely between centres as its definition is very variable. The purpose of this study was to define a parameter for DGF and immediate graft function (IGF) and to compare the graft outcome between these groups at our centre.
  
  
  METHODS
  The renal allograft function of 972 first cadaveric transplants performed between 1990 and 2001 in the Republic of Ireland was examined. The DGF and IGF were defined by a creatinine reduction ratio (CRR) between time 0 of transplantation and day 7 post-transplantation of <70 and >70%, respectively. Recipients with reduced graft function (DGF) not requiring dialysis were defined as slow graft function (SGF) patients. The serum creatinine at 3 months, 6 months, 1, 2 and 5 years after transplantation was compared between these groups of recipients. The graft survival rates at 1, 3 and 5 years and the graft half-life for DGF, SGF and IGF recipients were also assessed.
  
  
  RESULTS
  Of the 972 renal transplant recipients, DGF was seen in 102 (10.5%) patients, SGF in 202 (20.8%) recipients and IGF in 668 (68.7%) patients. Serum creatinine levels were significantly different between the three groups at 3 and 6 months, 1, 2 and 5 years. Graft survival at 5 years for the DGF patients was 48.5%, 60.5% for SGF recipients and 75% for IGF patients with graft half-life of 4.9, 8.7 and 10.5 years, respectively.
  
  
  CONCLUSIONS
  This study has shown that the CRR at day 7 correlates with renal function up to 5 years post-transplantation and with long-term graft survival. We have also demonstrated that amongst patients with reduced graft function after transplantation, two groups with significantly different outcomes exist.
authors.affiliation: Department of Nephrology, Beaumont Hospital, Beaumont, Dublin 9, Ireland. olwyn.johnston@ucd.ie
authors.forename: Olwyn
authors.initials: O
authors.lastname: Johnston
authors.forename: Patrick
authors.initials: P
authors.lastname: O'kelly
authors.forename: Susan
authors.initials: S
authors.lastname: Spencer
authors.forename: John
authors.initials: J
authors.lastname: Donohoe
authors.forename: J Joseph
authors.initials: JJ
authors.lastname: Walshe
authors.forename: Dilly M
authors.initials: DM
authors.lastname: Little
authors.forename: David
authors.initials: D
authors.lastname: Hickey
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Conlon
mesh_terms: D000328:Adult; D002102:Cadaver; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D003404:Creatinine