Background: Delayed graft function (DGF) occurs at variable rates in renal transplant recipients. It can be deleterious to renal allograft in long term. Various factors lead to the development of DGF. One of the risk factors is prolonged ischemic times. Anastomotic time (AT) adds to secondary warm ischemic insult to the new kidney. However, the impact of AT on DGF is not very clear. We aimed to analyse the incidence of delayed graft function in our center and assess the risk factors associated with development of DGF.

Method: All consecutive renal transplant recipients at our center from 2006 were included. Data was gathered from electronic health records of our department where it is recorded prospectively. Patients were divided into two groups based on presence or absence of delayed graft function, which was defined as requirement of dialysis in first-week post-transplant. Since the data was not normally distributed, non-parametric tests were used to compare AT of two groups. The relationship was then determined by binary log regression using other confounders in the model like age and sex of recipient, donor's age, cold ischemia time, presence or absence of multiple arteries. Data was analysed using SPSS ver.20.

Results: 186 deceased donor renal transplant recipients were investigated for the study. 62.4% recipients were male. Median age of recipient was 54.29 years (IQR 43.64, 63.42) and median donor age was 54.72 years (IQR 43.06, 64.81). 58/186 (31.2%) of deceased donor recipients experienced DGF. Median AT was 43 min. (IQR 36, 50). Median Cold ischemia time was 840 min (IQR 69, 990). There was a statistical significant difference between AT of recipients who developed DGF compared to those who did not (p=0.002). No statistically significant difference was found in cold Ischemia times of the two groups. In Binary logistic regression test, AT was independently associated with DGF (Odds ratio 1.04 per minute, 95% CI 1.012, 1.072 p= 0.006). Every minute increment in anastomotic time after 25 minutes increased the risk of DGF by 4%.

Conclusion: Significant proportion (31.2%) of deceased donors developed DGF. Anastomotic time had significant impact on the development of DGF hence should be minimised. Further study to address factors leading to increased anastomotic time would help to identify potentially modifiable factors to reduce DGF rates.

CITATION INFORMATION: Heer M, Trevillian P, Hibberd A. Longer Anastomotic Time Leads to Delayed Graft Function. Am J Transplant. 2017;17 (suppl 3).

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