In this study we sought to determine the risk for delayed graft function (DGF) in kidney transplants (Tx) with deceased donors (DD) through the analysis of clinical and genetic factors of donors and recipients. The analysis included 200 Tx performed in a single center, between 2007 and 2012. DGF was defined as the need for dialysis in the first week after Tx and occurred in 51% (102/200) of the Tx. Donor terminal serum creatinine (Cr) > 1.5 mg/dL was the only clinical variable that remained associated with DGF in a multivariate analysis that included clinical variables of donors (age, extended criteria donor, trauma or not trauma death, terminal serum creatinine, recipient/donor body mass index, cold ischemia time, warm ischemia time) and recipients (age, time on dialysis). The genetic polymorphisms, determined by TaqMan OpenArrayTM Genotyping System® (Life Technologies), were selected from a previous study and included: VEGFA (Vascular Endothelial Growth Factor A) rs2146323 in the donors, being the genotypes AA or AC associated with DGF, and GSTP1 (Glutathione S-Transferase P1) rs1871042 in the recipients, being the genotypes TT or TC associated with DGF. The combination of donor Cr >1.5 mg/dL and VEGFA AA or AC genotypes conferred higher risk for DGF in relation to donors with only one or none of these markers (DGF prevalence: 76% vs 41.8%, p <0.0001, OR 4.5, 95% CI: 2.1 – 9.8). The prevalence of DGF in transplants performed with kidneys from these high risk donors was not affected by the GSTP1 genetic polymorphism of the recipient. On the other hand, in transplants with low risk donors the prevalence of DGF was higher in recipients carrying the high than the low risk GSTP1 genotypes (51% vs 32%, p < 0.03, OR 2.2, 95% CI: 1.1 – 4.6). In conclusion, the combination of terminal donor creatinine and genetic polymorphisms in the VEGFA gene of the donor and in the GSTP1 gene of the recipient is valuable to stratify the risk for DGF in Tx with DD.

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