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Kidney Week

Abstract: TH-PO920

Comparison between Delayed Graft Function and Slow Graft Function in Predicting Outcomes amongst Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Schreiber, Brittany Lauren, University of Texas Medical Branch , Galveston, Texas, United States
  • Patankar, Rohan, University of Texas Medical Branch , Galveston, Texas, United States
  • Chaudhary, Vishy, University of Texas Medical Branch , Galveston, Texas, United States
  • Shah, Sujan P, University of Texas Medical Branch , Galveston, Texas, United States
  • Mujtaba, Muhammad Ahmad, University of Texas Medical Branch , Galveston, Texas, United States
Background

Allograft dysfunction in the immediate post transplant period, commonly referred to as delayed graft function (DGF), has been associated with poor outcomes including acute rejection and decreased allograft longevity. Defining DGF continues to remain controversial with multiple definitions in literature. The United Network for Organ Sharing (UNOS) defines DGF as dialysis within the first week of transplantation (UNOS-DGF), leaving other measures of allograft dysfunction under the umbrella of slow graft function (SGF). Initiation of dialysis remains subjective and varies in different institutions. We aim to compare UNOS-DGF with SGF in predicting poor patient outcomes and long-term allograft dysfunction.

Methods

Our study was a single center, retrospective study that included 154 renal transplant recipients from January 1, 2015 - May 1, 2017. The patients were divided into 4 groups based on graft function: i) DGF, ii). SGF (creatinine reduction ratio <0.3 in the first 48 hours post transplant), iii). combined group and iv). immediate graft function (IGF). Chart review was performed and data collected including patient demographics, length of stay (LOS), 30-day-readmission rates, incidence of graft loss, and creatinine at 1 month post transplant.

Results

Of the 154 patients, 34 were included in the DGF group, 71 in the SGF group, 23 in the combined group, and 72 in the IGF group. Patients in the DGF and combined groups were noted to have significantly increased LOS by more than 200% and higher 30 day readmission rates compared to the IGF group with a relative risk increase of 1.68 and 1.57 respectively. Creatinine at 1 month post-transplant was significantly higher amongst the DGF, SGF and combined groups, with the greatest statistical difference in the SGF. Graft loss was seen in 13% of patients in the combined group as compared to 9%, 6%, and 3% in the DGF, SGF, and IGF groups respectively.

Conclusion

We observed that while the UNOS-DGF definition correlated with worse patient outcomes and impaired allograft function at 1 month post-transplantation, the SGF criteria identified patients at risk that were not defined by UNOS-DGF and therefore may better predict poor patient outcomes and long-term allograft dysfunction.