Incidence and factors associated with delayed graft function in renal transplantation at Carlos Van Buren Hospital, January 2000 to June 2008.
Delayed graft function (DGF) is defined as the need for dialysis within the first week after renal transplantation, and slow graft function as persistence of serum creatinine concentration of at least 3 mg/dL on day 5 after the procedure. In the present study, we analyzed the incidence and risk factors for DGF at our center. This retrospective study included 106 patients who underwent renal transplantation between January 2000 and June 2008. Of these, 11 patients were excluded. Two of the remaining 95 patients received organs from living donors, and 93 received cadaver organs. Variables analyzed included donor age, cause of death, cause of chronic renal failure, recipient age, method and time of long-term renal replacement therapy, residual diuresis, panel of reactive antibodies (PRA), HLA mismatch, sex compatibility, cold and warm ischemia times, biopsy-confirmed episodes of acute rejection, urine output in the operating room and in the first 24 hours after the procedure, and intraoperative induction therapy. Data were analyzed using the chi(2) and Fisher exact tests and analysis of variance, and are given as mean (SD) and frequency. Variables associated with DGF at univariate analysis (P < .05) were divided between risk factors and predictors of DGF for inclusion in logistic regression models. The incidence of DGF was 32.6%; slow graft function, 16.8%; and immediate graft function, 50.5%. Cold ischemia time longer than 20 hours (P = .02) and donor age (P = .008) were directly associated with DGF. Twenty-four-hour urine output was a strong predictor of DGF. Patients with DGF demonstrated a 25% incidence of an episode of acute rejection before discharge from the hospital. No difference in DGF was observed for use of intraoperative induction therapy.
Sáinz
M M
MM
Valparaíso University Internal Medicine Residency Program, Carlos van Buren Hospital, Valparaíso, Chile. macasainz@gmail.com
Toro
J C
JC
Poblete
H B
HB
Perez
L F
LF
Nicovani
V H
VH
Carrera
M G
MG
D001706:Biopsy; D002677:Chile; D051799:Delayed Graft Function / Q000453:epidemiology* / Q000503:physiopathology; D006084:Graft Rejection / Q000453:epidemiology / Q000473:pathology; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000502:physiology* / Q000706:statistics & numerical data*; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome