Delayed Graft Function in Living Donor Kidney Transplantation: Risk Factors and Outcomes
1Tulane University School of Medicine, New Orleans, LA, 2Transplant Surgery, Tulane University School of Medicine, New Orleans, LA
Meeting: 2022 American Transplant Congress
Abstract number: 1034
Keywords: Graft function, Kidney transplantation, Living donor, Outcome
Topic: Clinical Science » Kidney » 40 - Kidney Living Donor: Other
Session Information
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Delayed graft function (DGF) following living donor kidney transplantation is less common and long-term outcomes are less understood. This single-center retrospective analysis of living donor kidney transplants was performed to determine risk factors for DGF and the effect of DGF on graft and patient survival.
*Methods: We analyzed all candidates who had received a kidney transplant from a living donor at our center between October 1999 and October 2017. Graft losses secondary to technical failures, hyperacute rejection, and primary nonfunction were excluded from the analysis.
*Results: Of the 435 candidates that met our criteria during the study period, 30 experienced delayed graft function (6.9%). Being a Black transplant recipient and receiving a kidney from a donor with a BMI of less than 25 were independent predictors of DGF in living donor transplant patients. The recipient to donor BMI ratio was higher in the DGF group, 1.11, compared to the non-DGF group, 1.04, however without statistical significance. Patients with DGF had prolonged hospital stay (11.3 vs. 5.53 days, p < .001) and significantly higher creatinine levels on discharge than patients without DGF (5.72 vs 1.17, p < 001). Acute rejection between transplant and discharge is more frequent in patients with DGF (19% vs 1.7%, p < .001). One-year graft survival among living donor kidney transplant recipients with DGF was significantly lower compared to patients who did not experience DGF (83.3% vs 95.1%, p = .008). Patients with DGF had a five-fold increased risk of graft failure within the first year following transplant (hazard ratio 5.1, 95% confidence interval: 1.2-22.3, p = .03). Graft survival of patients with DGF at 5 and 10 years was lower at 60% and 42% as compared to the non-DGF group at 75% and 43%, however without statistical significance. Patient survival in patients with DGF at 1, 5, and 10 years were 90%, 80%, and 55% as compared to 96%, 80%, and 47% in the non-DGF group.
*Conclusions: We report DGF to have a detrimental impact on 1-year graft survival in living donor kidney recipients. Further exploration into the risk factors for DGF following living donor kidney transplants using larger patient populations is warranted. Minimizing modifiable risk factors may improve outcomes in living donor kidney transplantation.
To cite this abstract in AMA style:
Defelice G, Paramesh A, Jeon H, Atiemo K, Killackey M, Vijay A. Delayed Graft Function in Living Donor Kidney Transplantation: Risk Factors and Outcomes [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/delayed-graft-function-in-living-donor-kidney-transplantation-risk-factors-and-outcomes/. Accessed May 16, 2025.« Back to 2022 American Transplant Congress