title: Delayed graft function: risk factors and the effects of early function and graft survival.
abstract: BACKGROUND
  Delayed graft function (DGF), a well-known immediate postoperative complication is defined as the need for dialysis during the first week after deceased donor kidney transplantation. It affects 25% to 50% of recipients. In this study we identified risk factors for DGF and its impact on patient and graft survivals.
  
  
  METHODS
  We retrospectively analyzed medical records from renal transplant recipients aged above 18 years who received a deceased donor kidney graft between November 2008 and December 2011, excluding kidney losses during the first week.
  
  
  RESULTS
  Among 137 transplantations, 64 (46.5%) displayed DGF. Multivariate analysis showed secondary renal disease (OR 3.7, CI 1.36-10.30; P = .011), HLA mismatches > 3 (OR 4.4, CI 1.53-12.51; P = .006) and donor urine output ≤ 3000 ml/24h (OR 25.8, CI 3.60-185.70; P = .001) to be significant risk factors for DGF. The hospitalization time was longer in the DGF group (38,2 ± 20,75 vs. 25,6 ± 8,18; P < .001). At 1 month, DGF group showed worse graft function based upon serum creatinine: 207.7 ± 148.52 vs 118.1 ± 36.63 μmol/L (P < .001). At 1 year follow-up, incidence of biopsy-proven acute renal rejection episodes was higher in the DGF (28; 51,9%) vs. the non-DGF group (18; 33,3%; P = .05). The 1-year recipient survival in DGF and no DGF groups were 90% vs 97% respectively (P = .124). With 1-year death censored graft survivals of 92% vs 100% respectively (P = .062).
  
  
  CONCLUSIONS
  Secondary renal disease, HLA mismatches and lower donor urinary output were associated with a greater incidence of DGF, leading to prolonged hospitalizations and an increased risk for an acute rejection episode.
authors.affiliation: Vilnius University, Vilnius University Hospital, Santariskiu Klinikos, Vilnius, Lithuania. marius.miglinas@santa.lt
authors.forename: M
authors.initials: M
authors.lastname: Miglinas
authors.forename: L
authors.initials: L
authors.lastname: Supranaviciene
authors.forename: K
authors.initials: K
authors.lastname: Mateikaite
authors.forename: K
authors.initials: K
authors.lastname: Skebas
authors.forename: A
authors.initials: A
authors.lastname: Kubiliene
mesh_terms: D000328:Adult; D051799:Delayed Graft Function; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014019:Tissue Donors; D055815:Young Adult