ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: SA-PO1046

Detrimental Outcomes Associated with Kidney Delayed Graft Function Persist Beyond the Short-Term

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Patel, Dave B, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Schindler, Paul, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Ylagan, Camille, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Bregman, Adam Philip, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Mandelbrot, Didier A., University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Astor, Brad C., University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Parajuli, Sandesh, University of Wisconsin-Madison, Madison, Wisconsin, United States
Background

Delayed graft function (DGF) is associated with acute rejection and decreased graft survival mainly in the early post-transplant period. However, its impact beyond this time is not well known.

Methods

All deceased donor kidney-only transplant recipients at our center between 01/2000 and 06/2021 were stratified based on DGF status (+ vs. –). Adjusted hazard ratios (aHR) of uncensored graft failure (UGF), death-censored graft failure (DCGF), death with a functioning graft (DWFG), and acute rejection (AR) were analyzed within the short-term (0-6 months) and mid-term (7-36 months).

Results

Out of 3093 recipients, 894 (28.9%) experienced DGF. Table 1 contains the aHR values for DGF + recipients comparing all four outcomes in the short- and mid-term. In the short-term, DGF was associated with an increased risk for UGF, DCGF, DWFG, and AR. Even in the mid-term outcomes, DGF was associated with an increased risk for UGF (aHR: 1.41, 95% CI: 1.13-1.77) and DWFG (aHR: 1.60, 95% CI: 1.15-2.36), but not for DCGF (aHR: 1.25, 95% CI: 0.93-1.70) or AR (aHR: 1.11, 95% CI: 0.78-1.58) [Table 1]. Figure 1 contains the Kaplan-Meier curves comparing the outcomes among DGF + and – recipients over 36 months.

Conclusion

Recipients with DGF remained at significantly higher risk of UGF and DWFG beyond the first 6 months, although the associations were weaker than during the first 6 months. Close follow-up for patients with DGF may mitigate these mid-term outcomes.

Table 1: Association of DGF with short- and mid-term outcomes

Figure 1: Kaplan-Meier Curves of Outcomes

Digital Object Identifier (DOI)