Kidney Transplant Outcomes after Prolonged Delayed Graft Function
Background: The protracted recovery of renal function may be an actionable marker of post-transplant adverse events, but a paucity of data are available to determine if the duration of graft recovery serves to stratify risk. Materials and Methods: Single-center data of adult-isolated deceased-donor...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/6/1535 |
| _version_ | 1797470549962653696 |
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| author | Cullan V. Donnelly Maria Keller Liise Kayler |
| author_facet | Cullan V. Donnelly Maria Keller Liise Kayler |
| author_sort | Cullan V. Donnelly |
| collection | DOAJ |
| description | Background: The protracted recovery of renal function may be an actionable marker of post-transplant adverse events, but a paucity of data are available to determine if the duration of graft recovery serves to stratify risk. Materials and Methods: Single-center data of adult-isolated deceased-donor kidney transplant (KTX) recipients between 1 July 2015 and 31 December 2018 were stratified by delayed graft function (DGF) duration, defined as time to serum creatinine < 3.0 mg/dL. Results: Of 355 kidney transplants, the time to creatinine < 3.0 mg/dL was 0–3 days among 96 cases (DGF ≤ 3), 4–10 days among 85 cases (DGF4-10), 11–20 days among 93 cases (DGF11-20), and ≥21 days for 81 cases (DGF ≥ 21). DGF ≥ 21 recipients were significantly more likely to be male, non-sensitized, and receive kidneys from donors that were older, with donation after circulatory death, non-mandatory share, hypertensive, higher KDPI, higher terminal creatinine, and longer cold and warm ischemia time. On multivariate analysis, DGF ≥ 21 was associated with a 5.73-fold increased odds of 12-month eGFR < 40 mL/min compared to DGF ≤ 3. Lesser degrees of DGF had similar outcomes. Conclusions: Prolonged DGF lasting over 20 days signifies a substantially higher risk for reduced eGFR at 1 year compared to lesser degrees of DGF, thus serving as a threshold indicator of increased risk. |
| first_indexed | 2024-03-09T19:37:48Z |
| format | Article |
| id | doaj.art-b00255e194a343cb91db2ec14923cb10 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T19:37:48Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b00255e194a343cb91db2ec14923cb102023-11-24T01:47:46ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01116153510.3390/jcm11061535Kidney Transplant Outcomes after Prolonged Delayed Graft FunctionCullan V. Donnelly0Maria Keller1Liise Kayler2Jacobs School of Medicine and Biomedical Sciences, SUNY-University at Buffalo, 955 Main Street, Buffalo, NY 14203, USADepartment of Surgery, SUNY-University at Buffalo, 100 High Street, Buffalo, NY 14203, USAJacobs School of Medicine and Biomedical Sciences, SUNY-University at Buffalo, 955 Main Street, Buffalo, NY 14203, USABackground: The protracted recovery of renal function may be an actionable marker of post-transplant adverse events, but a paucity of data are available to determine if the duration of graft recovery serves to stratify risk. Materials and Methods: Single-center data of adult-isolated deceased-donor kidney transplant (KTX) recipients between 1 July 2015 and 31 December 2018 were stratified by delayed graft function (DGF) duration, defined as time to serum creatinine < 3.0 mg/dL. Results: Of 355 kidney transplants, the time to creatinine < 3.0 mg/dL was 0–3 days among 96 cases (DGF ≤ 3), 4–10 days among 85 cases (DGF4-10), 11–20 days among 93 cases (DGF11-20), and ≥21 days for 81 cases (DGF ≥ 21). DGF ≥ 21 recipients were significantly more likely to be male, non-sensitized, and receive kidneys from donors that were older, with donation after circulatory death, non-mandatory share, hypertensive, higher KDPI, higher terminal creatinine, and longer cold and warm ischemia time. On multivariate analysis, DGF ≥ 21 was associated with a 5.73-fold increased odds of 12-month eGFR < 40 mL/min compared to DGF ≤ 3. Lesser degrees of DGF had similar outcomes. Conclusions: Prolonged DGF lasting over 20 days signifies a substantially higher risk for reduced eGFR at 1 year compared to lesser degrees of DGF, thus serving as a threshold indicator of increased risk.https://www.mdpi.com/2077-0383/11/6/1535kidney transplantallograft functiondelayed graft function |
| spellingShingle | Cullan V. Donnelly Maria Keller Liise Kayler Kidney Transplant Outcomes after Prolonged Delayed Graft Function Journal of Clinical Medicine kidney transplant allograft function delayed graft function |
| title | Kidney Transplant Outcomes after Prolonged Delayed Graft Function |
| title_full | Kidney Transplant Outcomes after Prolonged Delayed Graft Function |
| title_fullStr | Kidney Transplant Outcomes after Prolonged Delayed Graft Function |
| title_full_unstemmed | Kidney Transplant Outcomes after Prolonged Delayed Graft Function |
| title_short | Kidney Transplant Outcomes after Prolonged Delayed Graft Function |
| title_sort | kidney transplant outcomes after prolonged delayed graft function |
| topic | kidney transplant allograft function delayed graft function |
| url | https://www.mdpi.com/2077-0383/11/6/1535 |
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