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Recipient risk factors associated with delayed graft function: a paired kidney analysis
Mona D Doshi1, Neha Garg, Peter P Reese
1Department of Internal Medicine, Wayne State University, Detroit, MI 48201, USA. mdoshi@med.wayne.edu
Transplantation
|February 15, 2011
Summary
Recipient factors like male sex, African American race, obesity, and diabetes increase the risk of delayed graft function (DGF) after kidney transplants. Managing modifiable risks may reduce DGF occurrence.
Area of Science:
- Nephrology
- Transplantation Immunology
- Organ Transplantation
Background:
- Delayed graft function (DGF) is a frequent complication following deceased donor kidney transplantation.
- DGF arises from a complex interaction between donor organ quality and recipient biological factors.
- Identifying recipient-specific risk factors is crucial for mitigating DGF.
Purpose of the Study:
- To investigate and identify recipient-specific risk factors associated with the development of DGF.
- To enhance understanding of the recipient's role in post-transplant kidney graft outcomes.
Main Methods:
- Retrospective cohort study utilizing United Network for Organ Sharing (UNOS) data.
- Analysis of adult kidney-only transplant pairs from the same deceased donor with discordant DGF outcomes.
- Statistical analysis of recipient and donor characteristics, including wait times and cold ischemia duration.
Main Results:
- Recipients experiencing DGF were more likely to be male, African American, obese, diabetic, and on maintenance dialysis.
- Longer wait times, increased cold ischemia duration, and donor-recipient size mismatch were significant risk factors for DGF.
- Multivariable analysis identified high panel reactive antibody (PRA >10%) and low transplant center volume as additional DGF risk factors.
Conclusions:
- Multiple recipient characteristics are independently associated with DGF, even after controlling for donor factors.
- Modifiable recipient risk factors, including obesity, prolonged wait times, and extended cold ischemia, present opportunities for intervention.
- Targeted management of these recipient factors may reduce the incidence of delayed graft function in kidney transplantation.
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