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Multicenter Study
. 2021 Jun;34(6):1093-1104.
doi: 10.1111/tri.13865. Epub 2021 Apr 26.

Exploring the causes of the high incidence of delayed graft function after kidney transplantation in Brazil: a multicenter study

Tainá Veras de Sandes-Freitas  1   2 , Marilda Mazzali  3 , Roberto Ceratti Manfro  4 , Luis Gustavo Modelli de Andrade  5 , Alessandra Rosa Vicari  4 , Marcos Vinicius de Sousa  3 , José Osmar Medina Pestana  6   7 , Valter Duro Garcia  8 , Deise Rosa de Boni Monteiro de Carvalho  9 , Ronaldo de Matos Esmeraldo  2 , Claudia Maria Costa de Oliveira  10 , Denise Rodrigues Simão  11 , Luciane Mônica Deboni  12 , Elias David-Neto  13 , Frederico Castelo Branco Cavalcanti  14 , Álvaro Pacheco-Silva  7   15 , Gustavo Fernandes Ferreira  16 , Rafael Lage Madeira  17 , Alexandre Tortoza Bignelli  18 , Geraldo Sérgio Gonçalves Meira  19 , Euler Pace Lasmar  20 , Elizete Keitel  8   21 , Tereza de Azevedo Matuck  9 , Silvana Daher da Costa  1   2   10 , Hong Si Nga  5 , Paula Frassinetti Castelo Branco Camurça Fernandes  10 , Humberto Rebello Narciso  11 , Marcos Alexandre Vieira  12 , Fabiana Agena  13 , Ivailda Barbosa Fonseca  14 , Ana Cristina Carvalho de Matos  7   15 , Juliana Bastos  16 , Sandra Simone Villaça  17 , Silvia Regina Hokazono  18 , Alberto Rafael Baleeiro Silva  19 , Marcus Lasmar  20 , Hélio Tedesco-Silva  6   7 ; DGF-Brazil Study Group†
Collaborators, Affiliations
Free article
Multicenter Study

Exploring the causes of the high incidence of delayed graft function after kidney transplantation in Brazil: a multicenter study

Tainá Veras de Sandes-Freitas et al. Transpl Int. 2021 Jun.
Free article

Abstract

This retrospective multicenter (n = 18) cohort study evaluated the incidence, risk factors, and the impact of delayed graft function (DGF) on 1-year kidney transplant (KT) outcomes. Of 3992 deceased donor KT performed in 2014-2015, the incidence of DGF was 54%, ranging from 29.9% to 87.7% among centers. Risk factors (lower-bound-95%CI OR upper-bound-95%CI ) were male gender (1.066 1.2491.463 ), diabetic kidney disease (1.053 1.2961.595 ), time on dialysis (1.005 1.0071.009 ), retransplantation (1.035 1.3971.885 ), preformed anti-HLA antibodies (1.011 1.3831.892 ), HLA mismatches (1.006 1.0661.130 ), donor age (1.011 1.0171.023 ), donor final serum creatinine (sCr) (1.239 1.3171.399 ), cold ischemia time (CIT) (1.031 1.0431.056 ), machine perfusion (0.401 0.5420.733 ), and induction therapy with rabbit antithymocyte globulin (rATG) (0.658 0.8000.973 ). Duration of DGF > 4 days was associated with inferior renal function and DGF > 14 days with the higher incidences of acute rejection, graft loss, and death. In conclusion, the incidence and duration of DGF were high and associated with inferior graft outcomes. While late referral and poor donor maintenance account for the high overall incidence of DGF, variability in donor and recipient selection, organ preservation method, and type of induction agent may account for the wide variation observed among transplant centers.

Keywords: Brazil; delayed graft function; kidney transplant.

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References

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