The Scenario of Delayed Graft Function in Brazil

T. V. Sandes-Freitas¹, M. Mazzali², R. Manfro³, H. Tedesco-Silva⁴, L. Andrade⁵, V. Garcia⁶, E. Davi-Neto⁷, R. Esmeraldo⁸, C. Oliveira⁹, E. Lasmar¹⁰, R. Madeira¹¹, G. Ferreira¹², G. Meira¹³, F. Cavalcanti¹⁴, A. Bignelli¹⁵, D. Carvalho¹⁶, D. Pedroso¹⁷, L. Deboni¹⁸, A. Silva e Filho¹⁹, A. Vicari³, M. Sousa², .. on behalf of 'DGF multicêntrico' group²⁰

¹Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, Brazil, ²HC/UNICAMP, Campinas, Brazil, ³HCPA/UFRGS, Porto Alegre, Brazil, ⁴Hospital do Rim, São Paulo, Brazil, ⁵HC-Botucatu/UNESP, Botucatu, Brazil, ⁶Santa Casa de Porto Alegre, Porto Alegre, Brazil, ⁷HC/FMUSP, São Paulo, Brazil, ⁸H. Geral de Fortaleza, Fortaleza, Brazil, ⁹HUWC/UFC, Fortaleza, Brazil, ¹⁰H. Universitário São José, Belo Horizonte, Brazil, ¹¹H. Felício Rocho, Belo Horizonte, Brazil, ¹²Santa Casa de Juiz de Fora, Juiz de Fora, Brazil, ¹³Santa Casa de Montes Claros, Montes Claros, Brazil, ¹⁴Real Hospital Português, Recife, Brazil, ¹⁵H. Universitário Cajuru, Curitiba, Brazil, ¹⁶H. São Francisco na Providencia de Deus, Rio de Janeiro, Brazil, ¹⁷H. Santa Isabel, Blumenau, Brazil, ¹⁸H. Municipal São José, Joinville, Brazil, ¹⁹H. Israelita Albert Einstein, São Paulo, Brazil, ²⁰ABTO, São Paulo, Brazil

Meeting: 2020 American Transplant Congress

Abstract number: D-206

Keywords: Kidney transplantation, Preservation

Session Information

Session Name: Poster Session D: Non-Organ Specific: Organ Preservation/Ischemia Reperfusion Injury

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Unicenter Brazilian studies reported high incidences (50-70%) of delayed graft function (DGF). This is a multicenter Brazilian study aimed to evaluate the incidence, the risk factors and the impact of DGF in our peculiar scenario.

*Methods: Multicenter, retrospective cohort including deceased donor kidney transplants (KT) performed in 18 Brazilian centers between Jan/14-Dec/15 (n=4,156). 1-year outcomes were analyzed. DGF was defined as the need for dialysis in the first week after KT.

*Results: 27% of donors were expanded criteria, with KDPI 63±23%. Donor final creatinine (Crf) was 1.8±1.5mg/dL (Crf>1.5mg/dL in 39%). Eurocollins solution was used in 45%, 6% were machine perfused (MP), and cold ischemia time (CIT) was 22±7h. DGF incidence was 56% and it was associated with biopsy-proven acute rejection (16% vs. 7%, p<0.001), death-censored graft survival (92% vs. 96%, p<0.001) and patient survival (94 vs. 97%, p<0.001). Variables independently associated with DGF were: recipient BMI (OR 1.036, 95%CI 1.018-1.054), time on dialysis (OR 1.009, 95%CI 1.007-1.011), donor age (OR 1.013, 95%CI 1.008-1.018), Crf (OR 1.337, 95%CI 1.255-1.424), Eurocollins (OR 1.396, 95%CI 1.201-1.424), CIT (OR 1.052, 95%CI 1.040-1.064), and MP (OR 0.583, 95%CI 0.444-0.765).

*Conclusions: DGF incidence in Brazil is high and negatively impacts on KT outcomes. Among modifiable risk factors, we highlight the high incidence of donor acute kidney injury, the solution perfusion (Eurocollins) and the long CIT.

To cite this abstract in AMA style:

Sandes-Freitas TV, Mazzali M, Manfro R, Tedesco-Silva H, Andrade L, Garcia V, Davi-Neto E, Esmeraldo R, Oliveira C, Lasmar E, Madeira R, Ferreira G, Meira G, Cavalcanti F, Bignelli A, Carvalho D, Pedroso D, Deboni L, Filho ASilvae, Vicari A, Sousa M. The Scenario of Delayed Graft Function in Brazil [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-scenario-of-delayed-graft-function-in-brazil/. Accessed May 11, 2025.

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