Delayed graft function in living-donor renal transplantation: 10-year experience.
BACKGROUND
Delayed graft function (DGF), a dialysis requirement within a week after transplantation, can occur in deceased-donor renal transplantation. DGF is rare, in living-donor renal transplantation (LDRT) and its incidence and risk factors have not been established.


METHODS
We investigated the incidence and clinical characteristics of DGF in LDRT over 10 years. We compared HLA mismatches, panel reactive antibody status, frequency of nonrelated donors, donor age, sex match, recipient-donor body weight ratio, total ischemia time, and transplanted kidney weight between DGF and non-DGF patients.


RESULTS
The incidence of DGF in LDRT was 1.6%, which differed from earlier reports. HLA mismatch, female recipient frequency, and nonrelated donors were higher among the DGF group, but no risk factor for DGF was significant after multivariate logistic regression analysis. Biopsy findings showed 2 cases to be associated with rejection, 1 with acute pyelonephritis and 1 with acute tubular necrosis. The cases with rejection resulted in graft failure within 3 years after transplantation, but the other cases were followed with favorable graft function.


CONCLUSIONS
The incidence of DGF among LDRT was lower than that reported earlier studies, and the factors previously reported to cause DGF were not associated with DGF herein. Because DGF with rejection responses has a poor prognosis, strenuous strategies, including biopsy, should be performed in cases of DGF after LDRT.
Division of Nephrology, Department of Internal Medicine, Catholic University of Korea School of Medicine, Seoul, Korea.
H S
HS
Park
Y A
YA
Hong
H G
HG
Kim
S R
SR
Choi
I O
IO
Sun
B H
BH
Chung
B S
BS
Choi
C W
CW
Park
Y S
YS
Kim
C W
CW
Yang
D000328:Adult; D001706:Biopsy; D016009:Chi-Square Distribution; D051799:Delayed Graft Function / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome