Transplant International pp 5-7 | Cite as
Does delayed kidney graft function increase the risk of chronic rejection?
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Abstract
The impact of delayed graft function (DGF) on later renal graft loss due to chronic rejection was studied in a single center using uniform protocol for organ procurement and posttransplant patient care. DGF function was observed in 34% of 829 consecutive first cadaveric renal transplants in adults and in 47% of 169 retransplantations (P<0.05). There were no significant differences in graft survival between groups with early graft function (EGF) and DGF, either in first transplantations or retransplantations. The half-life in EGF and DGF groups of first transplants was 12.3 years and 10.5 years, respectively, and of retransplantants was 8.0 years and 6.5 years, respectively. DGF was divided in three subgroups according to the day of onset. If graft function started during the first or second week after transplantation there were no significant differences in long-term graft survival rates compared with EGF. Only in retransplants, if graft function started later than 2 weeks postoperatively, were long-term graft survival rates significantly lower when compared with EGF and the difference persisted if other causes of graft loss except chronic rejection were censored.
Key words
Chronic rejection Delayed graft function Graft outcomePreview
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References
- 1.Almond PS, Matas AJ, Gillingham KJ, et al (1993) Risk factors for chronic rejection in renal allograft recipients. Transplantation 55: 752–757PubMedCrossRefGoogle Scholar
- 2.Gulanikar AC, MacDonald AS, Sugurtekin U, Belitsky P (1992) The incidence and impact of early rejection episodes on graft outcome in recipients of first cadaver kidney transplants. Transplantation 53: 323–328PubMedCrossRefGoogle Scholar
- 3.Halloran PF, Aprile MA, Farewell V, Ludwin D, Smith K, Tsai SY, Bear RA, Cole EH, Fenton SS, Cattran DC (1988) Early function as the principal correlate of graft survival. Transplantation 46: 223–228PubMedCrossRefGoogle Scholar
- 4.Isoniemi H, Kyllönen L, Eklund B, Höckerstedt K, Salmela K, Willebrand v E, Ahonen J (1995) Acute rejection under triple immunosuppressive therapy does not increase the risk of late first cadaveric renal allograft loss. Transplant Proc 27: 875–877PubMedGoogle Scholar
- 5.Miwa H, van Loenen M, Vanderwerf BA (1989) The long-term effect of delayed graft function on cadaveric renal transplants treated with low dose cyclosporine. In: P Terasaki (ed) Clinical transplants 1989. UCLA Tissue Typing laboratory, Los Angeles, pp 275–278Google Scholar
- 6.Sanfilippo F, Vaughn, WK, Spees EK, Lucas BA (1985) The effects of delayed graft function on renal transplantation. Transplant Proc 17: 13–15Google Scholar
- 7.Troppmann C, Gillingham KJ, Benedetti E, Almond PS, Gruessner R, Najarian JS, Matas AJ (1995) Delayed graft function, acute rejection, and outcome after cadaver renal transplantation. Transplantation 59: 962–968.PubMedCrossRefGoogle Scholar