Delayed graft function in living-donor renal transplantation: a single-center experience with 1537 patients

Objectives: To analyze the incidence, clinical characteristics and possible causes of delayed graft function (DGF) among a large number of living kidney transplant recipients at a single center. Patients and Methods: We analyzed the medical records of 1537 patients over 18 years of age who received a kidney transplant from a living donor between January 2003 and June 2014. The demographic characteristics of the patients, graft survivals, acute rejection rates and renal functions were compared between patients with and without DGF. Results: Longer dialysis time before transplantation (50.6 ± 53.1 vs. 31.4 ± 42.9 months; P<0.001) and lower donor GFR (48.2 ± 10.2 vs. 45.4 ± 13 months; P=0.014) were associated with a greater incidence of DGF in this series. The DGF cases showed a higher incidence of acute rejection episodes (19.9% vs. 4.8%), chronic graft dysfunction (10% vs. 1%), prolonged hospitalization (16.8 ± 6.7 days vs. 8.3 ± 5.6 days), and worse renal function after 1-year follow-up period compared with non-DGF patients. Conclusions: Longer dialysis time before transplantation and lower donor GFR were associated with a higher risk for DGF, with prolonged hospitalization time, worse graft prognosis and higher rates of acute rejection episodes and chronic graft dysfunction.