Factors influencing delayed graft function in deceased renal transplant: A single tertiary care center experience

Abstract

Introduction: Exponential increase in the number of chronic kidney disease cases and shortage of living renal donors have increased the demand of deceased donor renal transplant (DDRT) in India. Delayed graft function (DGF) is more commonly observed in deceased donor renal transplant recipient and is a risk factor for early graft loss. Materials and Methods: An ambispective observational analysis was conducted over 63 recipients of DDRT performed in our institute from January 2012 to January 2022. The donor factors, recipients' characteristics, and perioperative factors were analyzed for the association with DGF. Statistical analysis was undertaken using SPSS 27.0 software, considering P < 0.05 as statistically significant. Results: Among the 63 deceased donor renal transplant recipients, 16 (25.39%) developed DGF. The incidence of DGF was more in recipients with greater body mass index and previous sensitization. Recipients receiving kidneys from older, male, and hypertensive donors with less terminal urinary output were found to be more susceptible to develop DGF. Cold ischemia time was significantly prolonged in patients who developed DGF. The duration of hospital stay and serum creatinine level at the time of discharge and also during follow-up after 3 months were significantly higher in the DGF group. Although the stated observations persisted in the patients during the 12 months of follow-up, no statistically significant differences were found in the number of functional grafts. Conclusion: DGF has a detrimental effect on graft as well as recipient survival. A coordinated approach between the transplant team and intensivist can circumvent most of the factors leading to DGF, thus improving the overall outcome.