Factors That Influence Delayed Graft Function in Kidney Transplants: A Single-Center Paired Kidney Analysis.


Laboratory of Immunology and Experimental Transplantation (LITEX), Medical School of Sao Jose do Rio Preto (FAMERP), SP, Brazil; Kidney Transplant Unit, Hospital de Base/FUNFARME, Sao Jose do Rio Preto, SP, Brazil; Urology and Nephrology Institute, Sao Jose Rio Preto, SP, Brazil. Electronic address: [Email]


BACKGROUND : The risk factors associated with delayed graft function (DGF) and its impact in kidney transplant (KTx) outcomes remains controversial; it is possible that donor renal characteristics influence the initial graft function in KTx.
OBJECTIVE : Evaluate risk factors associated with DGF and its impact in KTx outcomes.
METHODS : One hundred six mate KTx mate recipients performed in a single center were grouped according to the presence or absence of DGF.
RESULTS : Donors were predominantly men (58%); 70% were standard criteria type, with a mean Kidney Donor Profile Index (KDPI) of 62% ± 28%, median age of 42 ± 15 and presenting hospitalization time of 6 ± 5 days. KTx recipients presented an overall DGF rate of 82%, lasting 12 ± 7 days. Pairs presenting DGF were older than pairs without DGF (P = .008), while cold ischemia time (CIT) was significantly shorter in the group without DGF compared to those presenting DGF (P = .003). The KDPI of the KTx pairs was significantly higher in pairs with DGF versus without DGF (P = .04). No statistically significant differences in 1 year allograft and patient survival were observed. Recipient age (odds ratio = 6.3, confidence interval = 1.5-25.8; P = .009) and CIT (odds ratio = 4.6, confidence interval = 1.2-17.7; P = .002) were significantly associated with DGF.
CONCLUSIONS : This study suggests that recipient age, cold ischemic time, and KDPI are factors associated with DGF. In addition, DGF had no impact on 1-year renal function, allograft, and patient survival. In the transplant conditions of our country, Brazil, CIT seems to represent an important variable to be managed, and the aim should be to reduce this factor as much as possible.