Delayed graft function in renal transplant recipients: risk factors and impact on 1-year graft function: a single center analysis.
Delayed graft function (DGF), a frequent complication after kidney transplantation, occurs among about 60% of recipients of kidneys from deceased donors. DGF has a multifactorial etiology. It is characterized by acute tubular necrosis (ATN) upon biopsy. In this study we sought to identify among a group of recipients of kidneys from deceased donors, the incidence, risk factors, and impacts on patient and graft survivals of DGF.


METHODS
We retrospectively analyzed medical records from renal transplant recipients aged >18 years who received a deceased donor kidney graft between January 2003 and December 2006. Kidneys lost during the first week posttransplantation were excluded from this series.


RESULTS
Among 165 transplants, 111 (67%) displayed DGF, defined as the need for dialysis during the first week posttransplantation. The incidence of DGF was higher among patients with a cold ischemia time (CIT) > 24 hours: 85% vs 60%, DGF vs no DGF (P < .05), as well as for grafts from older donors. After 1-year follow-up, the DGF group showed worse graft function (serum creatinine 1.6 +/- 0.7 vs 1.3 +/- 0.4 mg/dL; P < .05) as well as a greater incidence of graft loss.


CONCLUSIONS
Prolonged cold ischemia and older donor age were associated with a greater incidence of DGF in this series, leading to prolonged hospitalization, increased risk for an acute rejection episode, and reduced graft function and survival after 1 year.
Division of Nephrology, Department of Medicine, State University of Campinas-UNICAMP, Campinas, Brazil.
E J M
EJ
Bronzatto
K R
KR
da Silva Quadros
R L S
RL
Santos
G
G
Alves-Filho
M
M
Mazzali
D000328:Adult; D002102:Cadaver; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007511:Ischemia; D007674:Kidney Diseases / Q000145:classification / Q000601:surgery; D016030:Kidney Transplantation / Q000473:pathology / Q000502:physiology*; D007684:Kidney Tubules / Q000473:pathology*; D007902:Length of Stay; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012727:Sex Characteristics; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D055815:Young Adult