Evaluation of severity of delayed graft function in kidney transplant recipients

摘要

Background The most common definition of delayed graft function (DGF) relies on dialysis during the first week post-transplant and does not consider DGF severity. The impact of DGF severity on long-term graft outcome remains controversial. Methods We analysed 627 deceased-donor kidney transplant recipients (KTRs) transplanted in 2005-2015 at our centre for DGF severity, associated risk factors and long-term consequences of DGF. Results We found 349 (55.7) KTRs with DGF, which were classified into four groups according to DGF duration (0-1, 2-7, 8-14, >14 days) and were compared with KTR with no DGF. A longer duration of DGF was associated with progressive worsening of 10-year death-censored graft survival {no DGF: 88.3 95 confidence interval (CI) 82.4-94.2; 0-1 day: 81.3 95 CI 68.2-94.4, 2-7 days: 61.5 95 CI 43.1.1-79.9, 8-14 days: 66.6 95 CI 47.4-85.8, >14 days: 51.2 95 CI 33-69.4; P = 85, all DGF severity groups demonstrated reduced graft survival. However, in the 14 days DGF duration showed worse outcomes. Conclusions DGF had a duration-dependent effect on graft survival, which varied depending on the KDPI. Of note, 0- to 1-day DGF showed comparable results to no DGF in the whole cohort.