Delayed graft function on kidney transplant recipients

  • Rubén Schiavelli División Nefrología y Trasplante Renal, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires
  • Josefina Rosés División Nefrología y Trasplante Renal, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires
  • Daniel Di Tullio División Nefrología y Trasplante Renal, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires
  • Agustina Gautos División Nefrología y Trasplante Renal, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires
  • Roberto Sabbatiello División Nefrología y Trasplante Renal, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires
  • Mauricio Pattin División Nefrología y Trasplante Renal, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires
  • Miguel Raño División Nefrología y Trasplante Renal, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires
Keywords: kidney transplant, delayed graft function, complications in renal transplantation

Abstract

Introduction: Delayed graft function (DGF) is a common complication in renal transplant and has implications for its development. Objectives: To know its incidence in a single transplant center, to describe the risk factors in donor and recipient, the procedure and the evolution of the graft and recipient. Methods: 178 renal transplant patients (P) with grafts from cadaveric donors were studied. Delayed graft function was defined as dialysis requirement in the first week post transplantation. We analyzed risk factors in the donor and recipient as well as the transplant procedures. Results: DGF incidence was 75.8% (135 patients). Risk factors for DGF were: greater cold ischemia time in minutes (1389 vs. 1224; P=0.01), greater recipient’s age in years (47.24 vs 40.71; P=0.001) and greater BMI of the donor (27.5 vs 25.17; P= 0.001). In 170 patients the presence of rejection was evaluated: those who had DGF presented more rejections (35.6% vs. 19.5%; P=0.046). The group with DGF showed lower graft survival at 5 years (P=0.0473), there was no difference in patient survival. Conclusion: The DGF incidence is higher than reported in the literature. Efforts should be made to reduce its incidence, focusing in reducing cold ischemia and improving maintenance of the donor.

References

Perico N, Cattaneo D, Sayegh MH, Remuzzi G. Delayed graft function in kidney transplantation. Lancet. 2004;364(9447):1814-27.

Siedlecki A1, Irish W, Brennan DC. Delayed graft function in the kidney transplant. Am J Transplant. 2011;11(11):2279-96.

Irish WD, Ilsley JN, Schnitzler MA, Feng S, Brennan DC. A risk prediction model for delayed graft function in the current era of deceased donor renal transplantation. Am J Transplant. 2010;10(10):2279-86.

Ojo AO, Wolfe RA, Held PJ, Port FK, Schmouder RL. Delayed graft function: risk factors and implications for renal allograft survival. Transplantation. 1997;63(7):968-74.

Hetzel GR, Klein B, Brause M, Westhoff A, Willers R, Sandmann W, et al. Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome. Transpl Int. 2002;15(1):10-6.

Rosenthal JT, Danovitch GM, Wilkinson A, Ettenger RB. The high cost of delayed graft function in cadaveric renal transplantation. Transplantation. 1991;51(5):1115-8.

Schiavelli R. Estudio multicéntrico y retrospectivo de incidencia de retardo de la función renal. IX Congreso Argentino de Trasplante, II Congreso Argentino de Enfermería en Trasplante. Nov 2007; Santa Fe (Argentina).

Helfer MS, Vicari AR, Spuldaro F, Gonçalves LF, Manfro RC. Incidence, risk factors, and outcomes of delayed graft function in deceased donor kidney transplantation in a Brazilian center. Transplant Proc. 2014;46(6):1727-9.

Carter JT, Chan S, Roberts JP, Feng S. Expanded criteria donor kidney allocation: marked decrease in cold ischemia and delayed graft function at a single center. Am J Transplant. 2005;5(11):2745-53.

Yarlagadda SG, Coca SG, Formica RN Jr, Poggio ED, Parikh CR. Association between delayed graft function and allograft and patient survival: a systematic review and meta-analysis. Nephrol Dial Transplant. 2009;24(3):1039-47.

Premasathian N, Avihingsanon Y, Ingsathit A, Pongskul C, Jittiganont S, Sumethkul V. Risk factors and outcome of delayed graft function after cadaveric kidney transplantation: a report from the Thai Transplant Registry. Transplant Proc. 2010;42(10):4017-20.

McCormack L, Dutkowski P, El-Badry AM, Clavien PA. Liver transplantation using fatty livers: always feasible? J Hepatol. 2011;54(5):1055-62.

Fridell JA, Mangus RS, Taber TE, Goble ML, Milgrom ML, Good J, et al. Growth of a nation part I: impact of organ donor obesity on whole-organ pancreas transplantation. Clin Transplant. 2011;25(3):E225-32.

Weissenbacher A, Jara M, Ulmer H, Biebl M, Bösmüller C, Schneeberger S, et al. Recipient and donor body mass index as important risk factors for delayed kidney graft function. Transplantation. 2012;93(5):524-9.

Bronzatto EJ, Da Silva Quadros KR, Santos RL, Alves-Filho G, Mazzali M. Delayed graft function in renal transplant recipients: risk factors and impact on 1-year graft function: a single center analysis. Transplant Proc. 2009;41(3):849-51.

Pratschke J, Kofla G, Wilhelm MJ, Vergopoulos A, Laskowski I, Shaw GD, et al. Improvements in early behavior of rat kidney allografts after treatment of the brain-dead donor. Ann Surg. 2001;234(6):732-40.

Weissenbacher A, Jara M, Ulmer H, Biebl M, Bösmüller C, Schneeberger S, et al. Recipient and donor body mass index as important risk factors for delayed kidney graft function. Transplantation. 2012;93(5):524-9.

Gavela Martínez E, Pallardó Mateu LM, Sancho Calabuig A, Beltrán Catalán S, Kanter Berga J, Ávila Bernabeu AI, et al. Delayed graft function after renal transplantation: an unresolved problem. Transplant Proc. 2011;43(6):2171-3.

Published
2017-04-24
How to Cite
1.
Schiavelli R, Rosés J, Di Tullio D, Gautos A, Sabbatiello R, Pattin M, Raño M. Delayed graft function on kidney transplant recipients. Rev Nefrol Dial Traspl. [Internet]. 2017Apr.24 [cited 2024Nov.25];35(4):182-7. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/39
Issue
Vol. 35 No. 4 (2015): Oct.-Dic.
Section
Original Article