*Purpose: Increased rates of delayed graft function (DGF) have been reported in the recipients of simultaneous liver and kidney (SLK) transplant. However, the effect of DGF on long-term kidney allograft are controversial. This study aims to determine the variables associated with DGF in patients with SLK transplant and its effect on the long-term kidney allograft outcomes.

*Methods: We analyzed the records of consecutive SLK recipients transplanted at our university hospital between 2010 and 2017.

*Results: We identified 60 SLK recipients during this period with a mean post transplant follow up of 4 ± 2.6 years. The overall incidence of DGF after SLK transplant was 47% (n=28). Multivariate analysis showed that pre-transplant dialysis > 6 weeks (HR=5.6, 95%Cl 1.23 to 25.59, p=0.02), pre-transplant albumin < 3 mg/dl (HR=5.75, 95%Cl 1.81 to 18.23, p=0.003), presence of pre-transplant diabetes (HR=2.5, 95%Cl 1.06 to 5.86, p=0.03) and donor after cardiac death (DCD) (HR=0.36, 95%Cl 0.13 to 0.97, p=0.04) were significant associated with post-transplant DGF. In the univariate analysis showed DGF (HR= 2.62, 95%Cl 0.96 to 7.15, p=0.05), Age > 55 years at time of transplant (HR=3.09 , 95%Cl 0.88 to 10.81, p=0.04), male sex (HR= 0.31, 95%Cl 0.11 to 0.84, p = 0.02) and pre-transplant albumin < 3 mg/dl (HR= 4.86, 95%Cl 1.07 to 21.98, p=0.04) were associated with increased kidney allograft loss or death, however only male sex (HR=0.32 , 95%Cl 0.11 to 0.87, p=0.03) was associated with the higher risk of graft loss or death in the multivariate analysis.

*Conclusions: Although our study was limited by a smaller sample size, we found that the incidence of DGF was high. However, with proper management, DGF didn’t have negative impact on the patient or graft survival.

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