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Kidney Week

Abstract: PO2417

Duration of Delayed Graft Function Predicts Kidney Allograft Function and Survival

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Kapoor, Sanjana, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • Alshoubaki, Nawras, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • Puttarajappa, Chethan M., University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • Hariharan, Sundaram, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
Background

The current study evaluated the duration of DGF as a measure of severity of ischemic injury to kidney transplant outcome.

Methods

This single center study evaluated DD kidney transplant recipients with DGF between Jan 2014 and Dec 2019. DGF was defined as the need for dialysis within 7 days post-transplant & were divided into three groups according to post transplant dialysis duration. Group I: dialysis <7 days, Group II: dialysis 8-14 days and Group III: dialysis >14 days. All primary & repeat adult kidney recipients of DD transplants were included. We excluded multiorgan recipients and pediatric en-bloc kidneys. We calculated eGFR over time using CKD EPI formula. Statistical analysis was performed to identify differences in variables, Linear Mixed Model for eGFR over time. Log-rank test was used to evaluate differences in graft & patient survival & composite end point (graft loss, patient loss & GFR, 20ml/min) for all 3 subgroups.

Results

A total of 132 DD KT recipients with DGF were identified: Group I: n=84 (64%), Group II: n=24 (18%) & Group III: n=24 (18%). The recipient/donor demographics and Donor (KDPI) & Transplant variables were similar across groups.Figure 1 (left) shows significantly lower eGFR values over time using linear mixed model among patients who needed dialysis for >14 days (Gr III vs I&II, P=0.006). Table 1 shows the incidence of Isolated Graft Loss, Patient death and combination of graft loss & patient death among 3 groups. Figure 1 (right) shows significantly lower composite end point (combination of patient loss, graft loss and impending graft loss) for among patients who needed dialysis for >14 days (P=0002).

Conclusion

In conclusion, we found a strong association between prolonged DGF>14 days with lower GFR values and survival outcomes. No differences in eGFR and survival rates were noted among patients with DGF patients < 7 days vs.7-14 days.

 Group I: Dialysis <7daysGroup II: Dialysis 7-14 daysGroup III: Dialysis >14 daysp-value
Graft loss, n(%)13 (15.5%)2 (8.3%)9 (37.5%)0.028
Patient death, n(%)11 (13.1%)5 (20.8%)8 (33.3%)0.07
Graft & patient loss, n(%)23 (27.4%)9 (37.5%)14 (58.3%)0.019

Funding

  • Clinical Revenue Support