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. 2008 Sep;23(9):2995-3003.
doi: 10.1093/ndt/gfn158. Epub 2008 Apr 11.

Marked variation in the definition and diagnosis of delayed graft function: a systematic review

Sri G Yarlagadda  1 , Steven G Coca, Amit X Garg, Mona Doshi, Emilio Poggio, Richard J Marcus, Chirag R Parikh
Affiliations

Marked variation in the definition and diagnosis of delayed graft function: a systematic review

Sri G Yarlagadda et al. Nephrol Dial Transplant. 2008 Sep.

Abstract

Background: The term delayed graft function (DGF) is commonly used to describe the need for dialysis after receiving a kidney transplant. DGF increases morbidity after transplantation, prolongs hospitalization and may lead to premature graft failure. Various definitions of DGF are used in the literature without a uniformly accepted technique to identify DGF.

Methods: We performed a systematic review of the literature to identify all of the different definitions and diagnostic techniques to identify DGF.

Results: We identified 18 unique definitions for DGF and 10 diagnostic techniques to identify DGF.

Conclusions: The utilization of heterogeneous clinical criteria to define DGF has certain limitations. It will lead to delayed and sometimes inaccurate diagnosis of DGF. Hence a diagnostic test that identifies DGF reliably and early is necessary. Heterogeneity, in the definitions used for DGF, hinders the evolution of a diagnostic technique to identify DGF, which requires a gold standard definition. We are in need of a new definition that is uniformly accepted across the kidney transplant community. The new definition will be helpful in promoting better communication among transplant professionals and aids in comparing clinical studies of diagnostic techniques to identify DGF and thus may facilitate clinical trials of interventions for the treatment of DGF.

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Figures

Fig. 1
Fig. 1
Flow chart for selection of studies. (1) Reasons for exclusion are not mutually exclusive; some studies have more than one reason for exclusion. (2) A study may belong to more than one category of DGF (diagnosis, risk factor, prognosis).
Fig. 2
Fig. 2
Different clinical conditions that present as early graft dysfunction. (A) Current definitions do not allow us to distinguish DGF from other causes of graft dysfunction. (B) With an improved definition and/or diagnostic technique patients with DGF can be correctly classified. Modified from the editorial ‘Acute kidney injury biomarkers: needs, present status, future promise’. Nephrology Self Assessment Program—Vol. 5, No. 2, March 2006.
See this image and copyright information in PMC

References

    1. Perico N, Cattaneo D, Sayegh MH, et al. Delayed graft function in kidney transplantation. Lancet. 2004;364:1814–1827. - PubMed
    1. Ojo AO, Wolfe RA, Held PJ, et al. Delayed graft function: risk factors and implications for renal allograft survival. Transplantation. 1997;63:968–974. - PubMed
    1. Koning OH, van Bockel JH, Van Der Woude FJ, et al. (European Multicenter Study Group on Organ Preservation). Risk factors for delayed graft function in University of Wisconsin solution preserved kidneys from multiorgan donors. Transplant Proc. 1995;27:752–753. - PubMed
    1. Sellers MT, Gallichio MH, Hudson SL, et al. Improved outcomes in cadaveric renal allografts with pulsatile preservation. Clin Transplant. 2000;14:543–549. - PubMed
    1. Gjertson DW. Impact of delayed graft function and acute rejection on kidney graft survival. Clin Transpl. 2000:467–480. - PubMed

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