Impact of delayed graft function on renal function and graft survival in deceased kidney transplantation

Renal Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine (Impact Factor: 0.87). 10/2010; 16(5):378-82.
Source: PubMed


To define the risk factors for delayed graft function and study the impact of such delays on renal function and long-term allograft survival in renal transplant recipients.
Single-centre retrospective study.
Regional hospital, Hong Kong.
Records of 118 Chinese renal transplant recipients from 1 July 1997 to 31 July 2005 were reviewed, and categorised into delayed and immediate graft function groups.
Delayed graft function was observed in about 19% of patients, for which cold ischaemic time was an important independent predictor. For each additional hour of cold ischaemic time, the odds ratio increased for delayed function by 0.002 (95% confidence interval, 0.001-0.003; P=0.03). Multivariate analysis revealed that neither cold ischaemic time nor delayed graft function was associated with acute rejection. On the other hand, at 1 year both delayed graft function (odds ratio=18.5; 95% confidence interval, 2.6-130.5; P=0.003) and donor age (1.2; 1.1-1.3; P=0.003) were related to a glomerular filtration rate of less than 30 mL/min. When renal function between patients with and without delayed graft function during the first 3 years was compared, it was significantly better in those without delayed graft function. However, there was no significant difference in death-censored graft survival between delayed graft function and immediate graft function groups.
Delayed graft function has a significant adverse effect on graft function at 1 year. Limiting cold ischaemic time is important as it is an independent predictor of delayed graft function.

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