Impact of Delayed Graft Function Duration on Long-Term Graft Survival After Kidney Transplantation

In patients with end-stage renal disease, kidney transplantation is the most recommended option for renal replacement therapy. However, due to the shortage of donor kidneys, the use of marginal kidneys has increased, leading to a higher incidence of delayed graft function (DGF). This study aimed to evaluate the effects of DGF and its duration on kidney transplantation outcomes.

A total of 1903 patients who underwent kidney transplantation between 2005 and 2020 were analyzed. DGF was defined as the need for dialysis within the first week after transplantation. Propensity score matching was used to ensure a balanced comparison between patients with DGF and those without DGF. Patients were further categorized based on the duration of DGF (group A': postoperative day 0-13, group B': postoperative day 14-). Graft survival was compared between these groups.

Diabetes mellitus, predialysis duration, kidney weight, and the duration of DGF were identified as significant risk factors for graft failure. The 10-year graft survival rate among all patients with DGF was 58.8%. When stratified by DGF duration, the 10-year graft survival rate was 85.4% in the no DGF group, 68.5% in group A', and 31.3% in group B'.

This study confirms that both the presence and prolonged duration of DGF adversely affect graft outcomes, particularly when dialysis is required for more than 14 days after transplantation.