Delayed Graft Function After DCD Kidney Transplantation:Risk Factors And Impact On The Outcome Of Transplantation

Objective:To evaulate the risk factors of Delayed graft function (DGF) and its impact on the outcome of transplantation in donation after citizen’s deceased (DCD) renal transplantation.Methods:Our transplant center conducted a retrospective study consistsed of56subjects who underwent DCD kidney transplantation from February2010to June2012. We analyzed the risk factors of DGF and its impact on the outcome of transplantation of23DGF cases. We classified the recipients into two groups:IGF (Immediate Graft Function) group (n=33) and DGF group (n=23).Results:DGF occurred in23of56(41.1%) kidenys from DCD donors, and the occurrence of DGF did not adversely influence patient’s survival (P=0.061) and graft survival (P=0.055). On univariate analysis, the preoperative dialysis time of recipient (P<0.001), HLA mismatch sites (P<0.001), the cause of brain death(P=0.027), BMI (P<0.001), preoperative serum creatinine of donors (P=0.0001), norepinephrine used in donors(P<0.001), warm ischema time(WIT)(P<0.001), cold ischemia time(CIT)(P<0.001) showed significant differences. On multivariate analysis, cerebral hemorrhage as the cause of brain death(P=0.052, hazard ratio [HR]:13.319), warm ischemia time>15min(P=0.004, HR:44.948) and the preoperative dialysis time of recipient>12months (P=0.011, HR:31.690) were independent risk factors for the development of DGF. Over a median follow-up period of9.3months (range0.4-27months), the graft survival rates of DGF group at3,6,12and18months after transplantation were86.1%,80.7%,75.3%,75.3%and the patients were90.0%,84.4%,78.8%,78.8%; the graft survival rates of IGF group at3,6,12and18months after transplantation were87.9%,84.5%,84.5%,84.5%and patients were100%,96.3%,96.3%,96.3%.Conclusions:The independent risk factors for DGF were the cause of brain death, the terminal creatinine level, and the preoperative dialysis time. In DCD kidney transplantation, DGF has no negative effect on1-year patient and graft survivals.