Duration of delayed graft function and outcomes after kidney transplantation from controlled donation after circulatory death donors: a retrospective study. (28th March 2019)

• Record Type: Journal Article
• Authors: Shamali, Awad; Kassimatis, Theodoros; Phillips, Benedict L.; Burton, Hannah; Kessaris, Nicos; Callaghan, Chris
• Is Part Of: Transplant international. Volume 32:Number 6(2019)
• Page Start: 635
• Page End: 645
• Publication Date: 2019-03-28
• Subjects: delayed graft function -- donation after circulatory death donor -- graft survival -- kidney transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.13403
• Languages: English
• ISSNs: 0934-0874

Abstract

Summary: The impact of the duration of delayed graft function (DGF) on graft survival is poorly characterized in controlled donation after circulatory death (DCD) donor kidney transplantation. A retrospective analysis was performed on 225 DCD donor kidney transplants between 2011 and 2016. When patients with primary nonfunction were excluded ( n = 9), 141 recipients (65%) had DGF, with median (IQR) duration of dialysis dependency of 6 (2–11.75) days. Longer duration of dialysis dependency was associated with lower estimated glomerular filtration rate at 1 year, and a higher rate of acute rejection. On Kaplan–Meier analysis, the presence of DGF was associated with lower graft survival (log‐rank test P = 0.034), though duration of DGF was not ( P = 0.723). However, multivariable Cox regression analysis found that only acute rejection was independently associated with lower graft survival [HR (95% CI) 4.302 (1.617–11.450); P = 0.003], whereas the presence of DGF and DGF duration were not. In controlled DCD kidney transplantation, DGF duration itself may not be independently associated with graft survival; rather, it may be that acute rejection associated with prolonged DGF is the poor prognostic factor.