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. 2021 Mar;53(3):439-446.
doi: 10.1007/s11255-020-02687-5. Epub 2021 Jan 4.

Risk factors for delayed graft function and their impact on graft outcomes in live donor kidney transplantation

Shivashankar Damodaran  1   2 , Brenna Bullock  3   4 , Obi Ekwenna  5   4 , Mehdi Nayebpour  6   4 , Naoru Koizumi  6   4 , Puneet Sindhwani  5   4 , Jorge Ortiz  5   4
Affiliations

Risk factors for delayed graft function and their impact on graft outcomes in live donor kidney transplantation

Shivashankar Damodaran et al. Int Urol Nephrol. 2021 Mar.

Abstract

Background: Delayed graft function (DGF) is a manifestation of acute kidney injury uniquely framed within the transplant process and a predictor of poor long-term graft function1. It is less common in the setting of living donor (LD) kidney transplantation. However, the detrimental impact of DGF on graft survival is more pronounced in LD2.

Purpose: To study the effects of DGF in the setting of LD kidney transplantation.

Methods: We performed a retrospective analysis of LD kidney transplantations performed between 2010 and 2018 in the UNOS/OPTN database for DGF and its effect on graft survival.

Results: A total of 42,736 LD recipients were identified, of whom 1115 (2.6%) developed DGF. Recipient dialysis status, male gender, diabetes, end-stage renal disease, donor age, right donor nephrectomy, panel reactive antibodies, HLA mismatch, and cold ischemia time were independent predictors of DGF. Three-year graft survival in patients with and without DGF was 89% and 95%, respectively. DGF was the greatest predictor of graft failure at three years (hazard ratio = 1.766, 95% CI: 1.514-2.059, P = 0.001) and was associated with higher rates of rejection (9% vs. 6.28%, P = 0.0003). Among patients with DGF, the graft survival rates with and without rejection were not different.

Conclusion: DGF is a major determinant of poor graft functional outcomes, independent of rejection.

Keywords: Delayed graft function; Graft rejection; Graft survival; Kidney transplantation; Living donors.

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References

    1. Wolfe RA et al (1999) Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 341(23):1725–1730 - PubMed
    1. Nemati E et al (2014) Does kidney transplantation with deceased or living donor affect graft survival? Nephrourol Mon 6(4):e12182 - PubMed - PMC
    1. Redfield RR et al (2016) Predictors and outcomes of delayed graft function after living-donor kidney transplantation. Transpl Int 29(1):81–87 - PubMed
    1. Orandi BJ et al (2015) Center-level variation in the development of delayed graft function after deceased donor kidney transplantation. Transplantation 99(5):997–1002 - PubMed - PMC
    1. Butala NM et al (2013) Is delayed graft function causally associated with long-term outcomes after kidney transplantation? Instrumental variable analysis. Transplantation 95(8):1008–1014 - PubMed - PMC

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