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Review
. 2022 Sep;36(9):e14779.
doi: 10.1111/ctr.14779. Epub 2022 Jul 27.

In kidney recipients from the same deceased donor, discordance in delayed graft function is associated with the worst outcomes

Elsadig A I Yousif  1 , Brenda Muth  1 , Venkata Manchala  1 , Jennifer Turk  1 , Justin Blazel  1 , Margaret Bloom  1 , Neetika Garg  1 , Fahad Aziz  1 , Maha Mohamed  1 , Arjang Djamali  1 , Didier Mandelbrot  1 , Sandesh Parajuli  1
Affiliations
Review

In kidney recipients from the same deceased donor, discordance in delayed graft function is associated with the worst outcomes

Elsadig A I Yousif et al. Clin Transplant. 2022 Sep.

Abstract

Introduction: Delayed graft function (DGF) is a common complication among deceased donor kidney transplant recipients (DDKTs) and is associated with worse outcomes. The effect on outcomes of concordance versus discordance in DGF between two different recipients of kidneys from the same donor is largely unknown.

Methods: We reviewed all adult DDKTs for which both kidneys were transplanted to two different recipients at our center between 2014-2019. DDKTs were divided into four groups based on the DGF status: concordance no DGF (cc-no-DGF); discordance no DGF(dd-no-DGF); discordance DGF (dd-DGF) and concordance in DGF (cc-DGF). Acute rejection (AR) and death censored graft failure (DCGF) were outcomes of interest.

Results: A total of 578 DDKTs fulfilled our selection criteria, 280were in cc-no-DGF, 83 in dd-no-DGF, 83 in dd-DGF, and 132 in cc-DGF. Compared to cc-no-DGF, in univariate analysis, dd-DGF was associated with an increased risk of AR (HR: 1.60; 95% CI: 1.0-2.56) but cc-DGF was not (HR: 1.01; 95% CI: 0.63-1.62). dd-DGF was not associated with an increased risk of AR in multivariate analysis. In multivariate analysis, dd-DGF was associated with an increased risk of DCGF (HR: 2.70; 95% CI: 1.05-6.93) but cc-DGFwas not (HR: 2.36; 95% CI: 0.97-5.70).

Conclusion: Discordance in DGF is associated with worse outcomes and may need closefollow-up and monitoring to improve the outcomes.

Keywords: DGF; donor characteristics; outcomes.

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