Delayed graft function in living donor kidney transplantation

Abstract

Dear Editor,This paper [1] made interesting reading but con-tains several contradictions which need to be discussed.The glaring issue is the confusion about the de ni-tion of delayed graft function (DGF). In materials and methods, the authors de ne DGF as the need for dialysis (HD) in the rst week after transplan-tation, which would then be expected to be the cri-terion for diagnosis of DGF throughout the study. However, in the background section, the same def-inition is termed “the older de nition”, and that it was subjective and not standardized. Importantly, the de nition of DGF used in the results section to calculate its incidence is also different, because it included recipients who did not require HD. Eleven of their 68 recipients (16%) were labeled DGF, but of whom, only 3 (4%) required dialysis? The remaining 8 recipients labeled DGF did not re-quire dialysis and should correctly be labeled slow graft function (SGF), although the day 5 serum cre-atinine is not available [2]. The authors did quote this paper on SGF but failed to recognize its rele-vance of SGF to their own study [2]. The DGF g-ure of 16% quoted by the authors is perhaps the incidence of the combined DGF and SGF, which is comparable to the incidence of poor early graft function in the other series [3–5]. The confusion about the de nition is also present in discussion, and the vital question the authors failed to address was exactly how they de ned DGF? This inconsist-ency in de ning DGF puts a question mark over the ndings of the entire study.