Marked variation in the definition and diagnosis of delayed graft function: a systematic review.
BACKGROUND
The term delayed graft function (DGF) is commonly used to describe the need for dialysis after receiving a kidney transplant. DGF increases morbidity after transplantation, prolongs hospitalization and may lead to premature graft failure. Various definitions of DGF are used in the literature without a uniformly accepted technique to identify DGF.


METHODS
We performed a systematic review of the literature to identify all of the different definitions and diagnostic techniques to identify DGF.


RESULTS
We identified 18 unique definitions for DGF and 10 diagnostic techniques to identify DGF.


CONCLUSIONS
The utilization of heterogeneous clinical criteria to define DGF has certain limitations. It will lead to delayed and sometimes inaccurate diagnosis of DGF. Hence a diagnostic test that identifies DGF reliably and early is necessary. Heterogeneity, in the definitions used for DGF, hinders the evolution of a diagnostic technique to identify DGF, which requires a gold standard definition. We are in need of a new definition that is uniformly accepted across the kidney transplant community. The new definition will be helpful in promoting better communication among transplant professionals and aids in comparing clinical studies of diagnostic techniques to identify DGF and thus may facilitate clinical trials of interventions for the treatment of DGF.
Yarlagadda
Sri G
SG
Section of Nephrology, Yale University and VAMC, 950 Campbell Ave., Mail Code 151B, Bldg 35 A, Room 219, West Haven, CT 06516, USA.
Coca
Steven G
SG
Garg
Amit X
AX
Doshi
Mona
M
Poggio
Emilio
E
Marcus
Richard J
RJ
Parikh
Chirag R
CR
D051799:Delayed Graft Function / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000473:pathology*; D009626:Terminology as Topic