Risk for Delayed Graft Function in Deceased Donor Renal Transplant Patients: A Single-Center Experience From North India

Transplant Proc. 2020 Jul-Aug;52(6):1741-1743. doi: 10.1016/j.transproceed.2020.04.003. Epub 2020 May 17.

Abstract

Objectives: Delayed graft function (DGF) in renal allograft transplantation refers to the need for dialysis in the first week after renal transplantation. This study analyzed the causes of DGF in deceased donor transplantation.

Methods: Data from January 2018 to July 2019 was reviewed with regard to donor and recipient characteristics such as demographics, biochemical parameters, organ dysfunction, and preterminal management. The recipients were divided into 2 groups: group I: patients without DGF and group II: patients with DGF.

Results: Kidneys were retrieved from 49 deceased donors (male:female = 41:8) and transplanted to 95 recipients (male:female = 60:35). Mean age of the donors and recipients was 35.34 ± 18.2 and 40.72 ± 13.30 years, respectively. The most common cause of brain death was central nervous system trauma (45 out of 49, 91%). In total, 20/95 (21%) recipients had DGF. Twelve recipients had received kidneys from donors who had circulatory arrest. Two patients were re-explored on postoperative day 1 for bleeding from renal artery anastomosis. The mean age in group I and group II was 28.65 ± 10.2 and 37.38 ± 12.28 years, respectively. The mean cold ischemia time in group I and group II was 398.73 ± 187.19 and 333.24 ± 115.49 minutes, respectively. The mean hospital stay of donor before donation in group I and group II was 4.34 ± 1.27 and 6 ± 2.95 days, respectively. The terminal donor creatinine in group I and group II was 0.88 ± 0.47 and 2.33 ± 1.73 mg/dL, respectively.

Conclusion: DGF in deceased donor transplantation may be attributed to donation after circulatory death, prolonged donor hospital stay, high donor leukocyte count, and high terminal creatinine.

MeSH terms

  • Adult
  • Brain Death
  • Cold Ischemia / adverse effects
  • Creatinine / analysis
  • Delayed Graft Function / etiology*
  • Delayed Graft Function / therapy
  • Female
  • Humans
  • India
  • Kidney / physiopathology
  • Kidney Transplantation / adverse effects*
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Renal Dialysis / statistics & numerical data
  • Time Factors
  • Tissue Donors / statistics & numerical data*
  • Transplantation, Homologous
  • Transplants / physiopathology

Substances

  • Creatinine