Proper management of delayed graft function (DGF) is essential for successful post-transplant result in deceased donor kidney transplantation. We compared the effect of anti-lymphocyte antibody (ALA) by use patterns of ALA (use or not, start day etc.).

A retrospective review of 106 recipients (31.2%) with DGF from 340 deceased donor kidney recipients was performed. Recipients with DGF were classified ALA-not use (n=59), ALA-early use (within post-operative 3 days) and ALA-late use (after post-operative 3 days) by ALA use pattern.

The recovery from DGF is different by use pattern of ALA. Early use group is required less dose and treatment duration compared to late use group. The early (within 3 months after transplantation) graft fail is not occurred in early use group, which is significantly different from late use group (41.7%) and not use group (11.9%) (p<0.0001). And early use group shows good prognosis in middle-term graft and patient survival analysis. In renal functional analysis of survival graft, early use group maintains a comparable renal function until 7 years after transplantation. But, ALA-not use and late use group shows persistent decline of renal function after post-transplant 3 years.

Early use of ALA in deceased donor kidney recipients with DGF can produce desirable middle-term graft survival and renal function.

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