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

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.

Effect of Perioperative Dexmedetomidine on Delayed Graft Function Following a Donation-After-Cardiac-Death Kidney Transplant

“… 6 Delayed graft function has been associated with ischemia-reperfusion injury 7 as well as a higher risk of acute rejection and reduced long-term allograft survival. 6 , 8 …”

Duration of delayed graft function and its impact on graft outcomes in deceased donor kidney transplantation

“…However, the data supporting poor outcomes associated with DGF, including rejection and graft survival, remains inconclusive. Some studies suggest decreased graft survival [ 4 , 5 ], which may be related to a higher rate of rejection [ 6 , 7 , 11 ]; others have not found an association between DGF and acute rejection or graft survival [ 12 ]. Delayed graft function is often multifactorial and related to a combination of the donor, transplant, and recipient factors.…”

Duration Of Delayed Graft Function And Its Impact On Graft Outcomes In Deceased Donor Kidney Transplantation Running Head: Impact of Duration of Delayed Graft Function

“…(1,2) DGF has historically been associated with inferior graft survival. (3)(4)(5)(6)(7) Although high KDPI, AKI, and DCD kidneys are at a higher risk for DGF, there are differences in the kidney allograft survival between the subgroups, with DCD and AKI donors having excellent outcomes. (8,9,10) DGF has increased resource utilization and concern for poor outcomes, including rejection and worse graft survival.…”

“…(8,9,10) DGF has increased resource utilization and concern for poor outcomes, including rejection and worse graft survival. (3)(4)(5)(6)(7) However, the data supporting poor outcomes associated with DGF, including rejection and graft survival, remains inconclusive. Some studies suggest decreased graft survival (4,5), which may be related to a higher rate of rejection (6,7,11); others have not found an association between DGF and acute rejection or graft survival.…”

“…(3)(4)(5)(6)(7) However, the data supporting poor outcomes associated with DGF, including rejection and graft survival, remains inconclusive. Some studies suggest decreased graft survival (4,5), which may be related to a higher rate of rejection (6,7,11); others have not found an association between DGF and acute rejection or graft survival. (12) Delayed graft function is often multifactorial and related to a combination of the donor, transplant, and recipient factors.…”