Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 4;21(1):526.
doi: 10.1186/s12882-020-02181-1.

Predictors and one-year outcomes of patients with delayed graft function after deceased donor kidney transplantation

Rao Chen  1   2 , Haifeng Wang  1   2 , Lei Song  1   2 , Jianfei Hou  1   2 , Jiawei Peng  1   2 , Helong Dai  3   4   5 , Longkai Peng  6   7
Affiliations

Predictors and one-year outcomes of patients with delayed graft function after deceased donor kidney transplantation

Rao Chen et al. BMC Nephrol. .

Abstract

Background: Delayed graft function (DGF) is closely associated with the use of marginal donated kidneys due to deficits during transplantation and in recipients. We aimed to predict the incidence of DGF and evaluate its effect on graft survival.

Methods: This retrospective study on kidney transplantation was conducted from January 1, 2018, to December 31, 2019, at the Second Xiangya Hospital of Central South University. We classified recipients whose operations were performed in different years into training and validation cohorts and used data from the training cohort to analyze predictors of DGF. A nomogram was then constructed to predict the likelihood of DGF based on these predictors.

Results: The incidence rate of DGF was 16.92%. Binary logistic regression analysis showed correlations between the incidence of DGF and cold ischemic time (CIT), warm ischemic time (WIT), terminal serum creatine (Scr) concentration, duration of pretransplant dialysis, primary cause of donor death, and usage of LifePort. The internal accuracy of the nomogram was 83.12%. One-year graft survival rates were 93.59 and 99.74%, respectively, for the groups with and without DGF (P < 0.05).

Conclusion: The nomogram established in this study showed good accuracy in predicting DGF after deceased donor kidney transplantation; additionally, DGF decreased one-year graft survival.

Keywords: Deceased donation; Delayed graft function; Graft survival; Nomogram; Predictors.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Nomogram for predicting the incidence of DGF. The statistically significant factors of binary logistical regression are shown in the nomogram, including CIT, WIT, pretransplant duration of dialysis, terminal Scr, primary cause of death and LifePort, successively. The risk of DGF was calculated, with the 95% CI shown. The code of creating the nomogram by R software is provided in Supplement 2. The weight and score of each predictor are shown in Supplement 3
Fig. 2
Fig. 2
Internal validation: AUC plot by LASSO. With the log (lambda) value corresponding to the minimum mean-squared error value, the AUC value produced from 10-fold cross-validation by LASSO was 83.12%
Fig. 3
Fig. 3
Calibration plot of the validation cohort. The x-axis represents the predicted DGF risk; the y-axis represents the actual DGF rate. The diagonal dashed line represents a perfect prediction by an ideal model and the dotted line the performance of the nomogram; the plot shows good agreement between the predicted probabilities and the observed prevalence of DGF
Fig. 4
Fig. 4
Kaplan–Meier plot of graft survival for DGF
See this image and copyright information in PMC

References

    1. Gaston RS. Improving long-term outcomes in kidney transplantation: towards a new paradigm of post-transplant care in the United States. Trans Am Clin Climatol Assoc. 2016;127:350–361. - PMC - PubMed
    1. Shoskes DA, Cecka JM. Deleterious effects of delayed graft function in cadaveric renal transplant recipients independent of acute rejection. Transplantation. 1998;66(12):1697–1701. - PubMed
    1. Irish WD, McCollum DA, Tesi RJ, Owen AB, Brennan DC, Bailly JE, Schnitzler MA. Nomogram for predicting the likelihood of delayed graft function in adult cadaveric renal transplant recipients. J Am Soc Nephrol. 2003;14(11):2967–2974. - PubMed
    1. Geddes CC, Woo YM, Jardine AG. The impact of delayed graft function on the long-term outcome of renal transplantation. J Nephrol. 2002;15(1):17–21. - PubMed
    1. Siedlecki A, Irish W, Brennan DC. Delayed graft function in the kidney transplant. Am J Transplant. 2011;11(11):2279–2296. - PMC - PubMed

Publication types

MeSH terms