In Kidney Recipients from the Same Deceased Donor, Discordance in Delayed Graft Function is Associated with Poor Outcomes
University of Wisconsin, Madison, WI
Meeting: 2022 American Transplant Congress
Abstract number: 1721
Keywords: Donation, Outcome, Risk factors
Topic: Clinical Science » Kidney » 46 - Kidney Complications: Non-Immune Mediated Late Graft Failure
Session Information
Session Name: Kidney Complications: Non-Immune Mediated Late Graft Failure
Session Type: Poster Abstract
Date: Tuesday, June 7, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Delayed graft function (DGF) is a common complication among deceased donor kidney transplant recipients (DDKTs) and is associated with worse outcomes. The effect on outcomes of concordance versus discordance in DGF between two different recipients of kidneys from the same donor is largely unknown.
*Methods: In this study, we reviewed all adult DDKTRs for which both kidneys were transplanted to two different recipients at our center between 2014-2019. DDKTRs were divided into three groups based on the DGF status as no DGF (nDGF), where both recipients did not need dialysis within one week post-transplant; discordance in DGF (dDGF), where only one recipient needed dialysis but not the other; and concordance in DGF (cDGF), where both recipients needed dialysis. Among dDGF, only recipients with DGF were included in the study, and those without DGF were excluded. Acute rejection (AR) and death censored graft failure (DCGF) were outcomes of interest.
*Results: A total of 495 DDKTs fulfilled our selection criteria, 280 were in nDGF, 83 in dDGF, and 132 in cDGF. Some of the donor characteristics were different among the groups, donors in the cDGF group were older, had higher terminal serum creatinine (Scr), higher KDPI, and likelihood of donation after circulatory death (DCD). There were no differences among the groups for some of the immunological risk factors including the degree of HLA mismatch, previous transplant and cPRA level. Most of the recipient’s baseline characteristics were also similar among the groups. In multivariate analysis, older donor’ age, higher terminal Scr, DCD, use of depleting induction, and early steroid withdrawal were associated with increased risk of DGF. Compared to nDGF, dDGF was associated with increased risk of AR (HR: 1.78; 95% CI: 1.08-2.93; p=0.02) but cDGF was not (HR: 1.39; 95% CI: 0.85-2.27; p=0.19). Similarly, dDGF was associated with an increased risk of DCGF (HR: 2.63; 95% CI: 1.02-6.76; p=0.04) but cDGF was not (HR: 2.23; 95% CI: 0.92-5.41; p=0.07).
*Conclusions: Discordance in DGF is associated with worse outcomes and may need close follow-up and monitoring to improve the outcomes. This study suggests that unlike cDGF, where donor factors have the predominant impact on outcomes, in dDGF, negative recipient factors predominate and have a great impact on outcomes.
To cite this abstract in AMA style:
Yousif EA, Muth B, Manchala V, Turk J, Blazel J, Bloom M, Garg N, Aziz F, Mohamed M, Djamali A, Mandelbrot D, Parajuli S. In Kidney Recipients from the Same Deceased Donor, Discordance in Delayed Graft Function is Associated with Poor Outcomes [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/in-kidney-recipients-from-the-same-deceased-donor-discordance-in-delayed-graft-function-is-associated-with-poor-outcomes/. Accessed May 18, 2025.« Back to 2022 American Transplant Congress