Background: Delayed graft function (DGF) is a common and significant complication in deceased donor kidney transplantation (DDKT). DGF is characterized by a temporary or permanent loss of kidney function after transplantation, which is associated with increased morbidity and mortality for transplant patients. But the exact cause of DGF is not well understood. The aim of this study is to identify the risk factors associated with DGF after the DDKT.
Methods: Between June 2011 and December 2022, 88 patients underwent DDKT at Department of Surgery at Konyang University Hospital, Daejeon, Korea. We compared two groups according to delayed graft: non-DGF group (n=75), delayed function group (n=13). The following characteristics were evaluated retrospectively through the medical records.
Results: The 5-year patient survival in the DGF group was 69.2% compared to 94.1% of the non-DGF group (P<0.001). The 5-year graft survival were 76.9% and 97.1% in the DGF group and non-DGF group (P=0.005) retrospectively. The estimated glomerular filtration rate (eGFR) level by period of recipients was significantly more increased in non-DGF group (1 week: 61.4±25.5 mL/min vs. 22.0±12.2 mL/min, P<0.001; 12th months: 73.0±22.2 mL/min vs. 47.8±14.5 ml/min, P=0.001) but the eGFR level of recipients at 60th months was not significantly different in both groups (79.8±21.5 mL/min vs. 79.7±13.6 mL/min, P=0.989). Also, we found that significant independent risk factors associated with DGF after DDKT were extended criteria donor (odds ratio [OR], 6.002; 95% confidence interval [CI], 1.586–22.722; P=0.008) and recipient body mass index >25 kg/m² (OR, 4.881; 95% CI, 1.249–19.074; P=0.023) in multivariate analysis. During the follow periods, pneumonia increase in the DGF group (30.8% vs. 16.0%, P=0.041) and AVN occurred two cases (15.4%) of DGF group (P=0.020).
Conclusions: We should anticipate a high possibility of DGF after DDKT, when recipients BMI is high or using the graft from extended criteria donor.