title: Incidence, risk factors, and outcomes of delayed graft function in deceased donor kidney transplantation in a Brazilian center.
abstract: BACKGROUND
  A high incidence of delayed graft function (DGF) after deceased donor kidney transplantation occurs in Brazil. The reasons for such have not been adequately studied.
  
  
  METHODS
  We performed a retrospective cohort study of 346 kidney transplant recipients from deceased donors. DGF risk factors related to the recipient, donor, and transplantation surgery were analyzed and correlated with graft outcomes. A logistic regression analysis was used to identify independent risk factors and patient and graft survival were assessed using Kaplan-Meier curves.
  
  
  RESULTS
  The incidence of DGF was 70.8% (245 cases). Our final model of multivariate analysis showed that DGF is associated (P < .05) with donor final serum creatinine (relative risk [RR], 1.84; 95% confidence interval [CI], 1.26-2.70), donor age (RR, 1.02 [1.0-1.033]), receiving a kidney from national offer (RR, 2.44 [1.06-5.59]), and need for antibody induction (RR, 2.87 [1.33-6.18]). Outcomes that were associated with DGF were longer length of hospital stay (32.5 ± 20.5 vs 18.8 ± 16.3 days; P = .01), higher incidence of acute rejection (37.8 vs 12.9%; P < .01), worse graft survival at 1 year (83.5% vs 93.9%; P < .01), and higher levels of serum creatinine at 3, 6, and 12 months (P < .05). There was no difference in patient survival and the occurrence of acute rejection did not influence the survival of patients or grafts.
  
  
  CONCLUSIONS
  DGF was associated with higher donor final serum creatinine, donor age, receiving a kidney from the national supply, and need for antibody induction. Most importantly, DGF was associated with worse outcomes.
authors.affiliation: School of Medicine, Federal University of Rio Grande do Sul, Brazil.
authors.forename: M S
authors.initials: MS
authors.lastname: Helfer
authors.affiliation: Division of Nephrology, Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: A R
authors.initials: AR
authors.lastname: Vicari
authors.affiliation: Division of Nephrology, Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Spuldaro
authors.affiliation: School of Medicine, Federal University of Rio Grande do Sul, Brazil; Division of Nephrology, Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: L F S
authors.initials: LF
authors.lastname: Gonçalves
authors.affiliation: School of Medicine, Federal University of Rio Grande do Sul, Brazil; Division of Nephrology, Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Brazil. Electronic address: rmanfro@hcpa.ufrgs.br.
authors.forename: R C
authors.initials: RC
authors.lastname: Manfro
mesh_terms: D000328:Adult; D000367:Age Factors; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001938:Brazil; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000209:etiology*; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors
chemical_list: D000911:Antibodies, Monoclonal; D003404:Creatinine