Saudi Journal of Kidney Diseases and Transplantation

ORIGINAL ARTICLE
Year
: 2013  |  Volume : 24  |  Issue : 2  |  Page : 243--246

Risk factors and consequences of delayed graft function


Mondher Ounissi1, Mejda Cherif1, Taieb Ben Abdallah1, Mongi Bacha1, Hafedh Hedri1, Ezzedine Abderrahim1, Rym Goucha1, Adel Kheder1, Riadh Ben Slama2, Amine Derouiche2, Mohamed Chebil2, Rafika Bardi3, Imen Sfar3, Yosr Gorgi3 
1 Department of Internal Medicine A, Charles Nicolle Hospital, Tunis, Tunisia
2 Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
3 Laboratory of Immunology (LR03SP01), Charles Nicolle Hospital, Tunis, Tunisia

Correspondence Address:
Mondher Ounissi
Department of Internal Medicine A, Charles Nicolle Hospital, Tunis
Tunisia

The impact of delayed graft function (DGF) on the outcome of renal transplantation remains controversial. We analyzed the risk factors for DGF and its impact on graft and patient survival. A total of 354 renal transplants performed between June 1986 and April 2000 were analyzed. Variables analyzed included donor and recipient age, method and duration of renal replacement therapy, HLA mismatch, cold and warm ischemia times, biopsy-confirmed acute rejection, length of stay in the hospital, serum creatinine at the end of first hospitalization as well as graft and patient survival at one, three, five and ten years. The study patients were divided into two groups: patients with DGF (G1) and those without DGF (G2). DGF occurred in 50 patients (14.1%), and it was seen more frequently in patients transplanted from deceased donors (60% vs. 40%, P <0.0001). The cause of DGF was acute tubular necrosis, seen in 98% of the cases. Univariate analysis showed a statistically significant difference between the two groups G1 and G2 in the following parameters: average duration on dialysis (52.3 vs. 36.4 months, P = 0.006), HLA mismatch (44.9% vs. 32.11% P = 0.015), donor age (35.9 vs. 40.2 years, P = 0.026), cold ischemia time (23 vs. 18.2 h, P = 0.0016), warm ischemia time (41.9 vs. 38.6 mn, P = 0.046), length of stay in the hospital during first hospitalization (54.7 vs. 33.2 days, P <0.0001), serum creatinine at the end of first hospitalization (140 vs. 112 μmol/L, P <0.0001) and at three months following transplantation (159 vs. 119 μmol/L, P = 0.0002). Multivariate analysis revealed the following independent risk factors for DGF: deceased donor (RR = 13.2, P <0.0001) and cold ischemia time (RR = 1.17, P = 0.008). The graft survival at one, three, five and ten years was 100%, 93%, 88.3% and 78.3% in G1 versus 100%, 95.9% 92.8% and 82.3% in G2; there was no statistically significant difference. The patient survival at one, three, five and ten years was 100%, 91.3%, 83.6% and 74.4% in G1 versus 100%, 95.9%, 94% and 82.6% in G2 with a statistically significant difference (P = 0.04). Prolonged cold ischemia time and transplantation of kidneys from deceased donors were the main risk factors for DGF in our study. Also, DGF significantly affected patient survival but had no influence on graft survival.


How to cite this article:
Ounissi M, Cherif M, Abdallah TB, Bacha M, Hedri H, Abderrahim E, Goucha R, Kheder A, Slama RB, Derouiche A, Chebil M, Bardi R, Sfar I, Gorgi Y. Risk factors and consequences of delayed graft function.Saudi J Kidney Dis Transpl 2013;24:243-246


How to cite this URL:
Ounissi M, Cherif M, Abdallah TB, Bacha M, Hedri H, Abderrahim E, Goucha R, Kheder A, Slama RB, Derouiche A, Chebil M, Bardi R, Sfar I, Gorgi Y. Risk factors and consequences of delayed graft function. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2022 May 24 ];24:243-246
Available from: https://www.sjkdt.org/article.asp?issn=1319-2442;year=2013;volume=24;issue=2;spage=243;epage=246;aulast=Ounissi;type=0