Association Between Perioperative Daprodustat Use and Early Posttransplant Graft Function in Living Donor Kidney...

Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors, such as daprodustat, have demonstrated nephroprotective effects in preclinical models. However, their potential benefits in living donor kidney transplantation (LDKT) remain unclear. This study aimed to evaluate the effects of daprodustat on early posttransplant graft functions in LDKT.

This single-center study evaluated LDKT recipients transplanted between August 2019 and November 2023. Patients were divided into the daprodustat group, who received the drug from preoperative Day 1 to postoperative Day 7, and the control group, who did not receive HIF-PH inhibitors during this period. Propensity score matching yielded 32 patients per group.

The daprodustat group exhibited better graft function, reflected by higher estimated glomerular filtration rates in the early posttransplant period (mean ± standard deviation: Week 1, 53.3 ± 16.1 vs control 41.9 ± 17.9 mL/min/1.73 m²; P = 0.001; Week 2, 55.3 ± 17.6 vs 46.0 ± 15.1; P = 0.008). The incidence of slow graft function was significantly lower in the daprodustat group (0.0% vs 12.5%, P = 0.039). No delayed graft function or thrombotic events occurred, and rejection did not differ between groups.

These findings raise the possibility that perioperative daprodustat use may be associated with improved early graft function in LDKT, warranting further investigation.