Introduction

Delayed graft function (DGF), defined as dialysis within the first week after kidney transplantation, is a common and known risk factor for impaired renal graft function. However, the impact of the number of dialysis sessions on graft survival in the long-term is poorly evaluated so far.

Methods

We conducted a retrospective long-term-observational study of a well-characterized cohort including 586 adult patients who received a deceased donor kidney over a period of 10 years. Demographics, clinical data and long-term outcomes over a period of up to 3 years posttransplant were assessed. Mean follow up was 2.73±0.71 years. For further analysis we defined 4 groups who received 0, 1-2, 3-5 and >5 dialysis sessions, respectively. Analyses were performed by Kaplan-Meier survival curves (log-rank test) or Chi square test using SPSS. All results were censored for death.

Results

Among 586 recipients 286 (48.8%) experienced DGF. After 3 years, 13.6% patients with DGF suffered from graft loss compared to 5.7% of patients without DGF (p= 0.001). Within the DGF groups patients with 1-2 (n= 130) and 3-5 dialysis sessions (n=71) showed no statistically significant difference in graft survival compared to patients without DGF. However, patients with >5 dialyses (n=85) showed significantly more graft losses (log rank p< 0.001) (Fig.1). Subanalysis of recipients >65 years (n=180), representing the Eurotransplant Senior Program, showed significance in the group >5 dialysis sessions (p=0.009), whereas in the group of 18-64 year old adults >10 dialysis sessions were necessary to impair graft outcome (p=0.031).

Summary

DGF is a predictor for graft loss in the long-term. Intriguingly, up to 5 posttransplant dialysis sessions do not influence the occurrence of graft loss whereas the need of more than 5 dialyses markedly promotes graft loss. Moreover, younger kidney recipients seem to preserve graft function despite prolonged delayed graft function.

« Back to 2015 American Transplant Congress