[Acute postoperative renal insufficiency in renal transplantation. Incidence and risk factors]

Delayed renal function (DFG) is known to influence both the short and long-term outcome of transplanted kidneys. Data collected retrospectively on all 129 cadaveric renal transplants performed between January 1991 and January 1993 within a single center were analyzed. 42 (32.55%) cases of acute renal failure (ARF) occurred during the immediate postoperative period and 28 patients required dialysis. When compared with immediate good allograft function, DGF was associated with previous failed transplant (7/15 vs 35/114, p = 0.01), donor age (39.2 +/- 13 vs 30.1 +/- 12 years, p = 0.01), and episodes of collapsus of the donor (11/25 vs 31/104, p < 0.01). The graft function of the recipient was not correlated with the serum creatinine of the donor. There was no apparent relationship between the cold ischemia or the anastomosis time and the occurrence of DGF. One-year patient and graft survival were similar in the two groups (respectively for the group ARF and without ARF: 96.4% and 96.5%; 88.8% and 89%), but patients with DGF had higher serum creatinine values at 12 months post DGF (185.6 +/- 44.8 mumol/l vs 157.5 +/- 30.8 mumol/l, p = 0.06). This study suggests that DGF is related to the characteristics of the donor graft and is more frequently encountered in previously transplanted recipients.