Impact of slow and delayed graft function on kidney graft survival between various subgroups among renal transplant patients.
OBJECTIVE
Renal allografts with excellent graft function show good long-term outcomes, while grafts with delayed function have been associated with poor long-term survivals, although few reports have analyzed outcomes among these groups. We compared first-week postoperative graft function among renal transplant patients to analyze the impact of slow graft function (SGF) and delayed graft function (DGF) on graft survival.


METHODS
Renal transplantations were performed from 362 unrelated, 46 related, and 163 deceased donors. Kidney transplant patients were divided into 3 groups according to their initial graft function. First-week dialyzed patients formed the DGF group. Nondialyzed patients were divided into a SGF or an excellent graft function (EGF) cohort according to whether the serum creatinine at day 7 was higher vs lower than 2.5 mg/dL, respectively.


RESULTS
Of the 570 renal transplant recipients, DGF was observed in 39 patients (6.8%), SGF in 64 (11.2%), and EGF in 467 (81.8%). There was no significant difference in SGF vs DGF between patients who received kidneys from unrelated vs related living or deceased donors. Graft survival was worse among the DGF than the SGF or EGF patients, with no significant difference between the last 2 groups. The 6-month graft survivals were 74%, 93%, and 96%; the 3-year graft survivals were 70%, 88%, and 90%, respectively (P < .001).


CONCLUSIONS
We observed a similar impact of EGF and SGF on kidney graft survival. Kidney transplant recipients who developed DGF showed worse graft survival than those with EGF or SGF.
Zeraati
A A
AA
Mashhad Transplant Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. ali_ze47@yahoo.com
Naghibi
M
M
Kianoush
S
S
Kianoosh
S
S
Ashraf
H
H
D000293:Adolescent; D000328:Adult; D002102:Cadaver; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000503:physiopathology*; D005190:Family; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000473:pathology / Q000502:physiology*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D011184:Postoperative Period; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
D003404:Creatinine