Open AccessDuration of delayed graft function and outcomes after kidney transplantation from controlled donation after circulatory death donors: a retrospective study
Author(s) -
Shamali Awad,
Kassimatis Theodoros,
Phillips Benedict L.,
Burton Hannah,
Kessaris Nicos,
Callaghan Chris
Publication year - 2019
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13403
Subject(s) - medicine , dialysis , kidney transplantation , proportional hazards model , retrospective cohort study , transplantation , urology , surgery , renal function , survival analysis , kidney
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.