Abstract
BackgroundDelayed graft function (DGF) is closely associated with the use of marginal donated kidneys due to deficits during transplantation and in recipients. We aimed to predict the incidence of DGF and evaluate its effect on graft survival.MethodsThis retrospective study on kidney transplantation was conducted from January 1, 2018, to December 31, 2019, at the Second Xiangya Hospital of Central South University. We classified recipients whose operations were performed in different years into training and validation cohorts and used data from the training cohort to analyze predictors of DGF. A nomogram was then constructed to predict the likelihood of DGF based on these predictors.ResultsThe incidence rate of DGF was 16.92%. Binary logistic regression analysis showed correlations between the incidence of DGF and cold ischemic time (CIT), warm ischemic time (WIT), terminal serum creatine (Scr) concentration, duration of pretransplant dialysis, primary cause of donor death, and usage of LifePort. The internal accuracy of the nomogram was 83.12%. One-year graft survival rates were 93.59 and 99.74%, respectively, for the groups with and without DGF (P < 0.05).ConclusionThe nomogram established in this study showed good accuracy in predicting DGF after deceased donor kidney transplantation; additionally, DGF decreased one-year graft survival.
Highlights
Delayed graft function (DGF) is closely associated with the use of marginal donated kidneys due to deficits during transplantation and in recipients
721 patients who met the inclusion criteria were enrolled, with 461 and 260 patients assigned to the training and validation cohorts, respectively (Figure S1 in the Supplement)
Univariate analysis of the training cohort With regard to the training cohort data, the proportion of expanded criteria donor (ECD) was 20.82%, and the incidence of DGF was 16.92%; ECD showed no statistical significance with the occurrence of DGF(P > 0.05)
Summary
Delayed graft function (DGF) is closely associated with the use of marginal donated kidneys due to deficits during transplantation and in recipients. We aimed to predict the incidence of DGF and evaluate its effect on graft survival. Our center utilizes expanded criteria donor (ECD) kidneys to address the shortage, which has been recognized by the Organ Procurement and Transplantation Network (OPTN) in recent years [7]. Kidney transplantations from pediatric donors were shown to be safe in a recent study [8]. Our center has adopted partial graft from young children (≤ 12 years) [9]; despite the difficulty of surgery, the youngest donor in this study was only 5 months old. Considering the contradiction between marginal kidneys and DGF, this retrospective study was conducted based on the medical records of our center to investigate pretransplant risk factors for DGF. We compared graft survival between DGF and non-DGF groups
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