NDT Advance Access published online on May 23, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl103
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1 Department of Nephrology, Beaumont Hospital, Beaumont, Dublin 9, Ireland
* To whom correspondence should be addressed. Background. Delayed graft function (DGF) is a common complication in cadaveric kidney transplants affecting graft outcome. However, the incidence of DGF differs widely between centres as its definition is very variable. The purpose of this study was to define a parameter for DGF and immediate graft function (IGF) and to compare the graft outcome between these groups at our centre. Methods. The renal allograft function of 972 first cadaveric transplants performed between 1990 and 2001 in the Republic of Ireland was examined. The DGF and IGF were defined by a creatinine reduction ratio (CRR) between time 0 of transplantation and day 7 post-transplantation of <70 and >70%, respectively. Recipients with reduced graft function (DGF) not requiring dialysis were defined as slow graft function (SGF) patients. The serum creatinine at 3 months, 6 months, 1, 2 and 5 years after transplantation was compared between these groups of recipients. The graft survival rates at 1, 3 and 5 years and the graft half-life for DGF, SGF and IGF recipients were also assessed. Results. Of the 972 renal transplant recipients, DGF was seen in 102 (10.5%) patients, SGF in 202 (20.8%) recipients and IGF in 668 (68.7%) patients. Serum creatinine levels were significantly different between the three groups at 3 and 6 months, 1, 2 and 5 years. Graft survival at 5 years for the DGF patients was 48.5%, 60.5% for SGF recipients and 75% for IGF patients with graft half-life of 4.9, 8.7 and 10.5 years, respectively. Conclusion. This study has shown that the CRR at day 7 correlates with renal function up to 5 years post-transplantation and with long-term graft survival. We have also demonstrated that amongst patients with reduced graft function after transplantation, two groups with significantly different outcomes exist.
Received February 7, 2006
Accepted February 21, 2006
Original Article
Reduced graft function (with or without dialysis) vs immediate graft function--a comparison of long-term renal allograft survival
Olwyn Johnston 1 *,
Patrick O'Kelly 1,
Susan Spencer 2,
John Donohoe 1,
J. Joseph Walshe 1,
Dilly M. Little 2,
David Hickey 2,
and
Peter J. Conlon 1
2 Department of Transplantation, Beaumont Hospital, Beaumont, Dublin 9, Ireland
Olwyn Johnston, E-mail: olwyn.johnston{at}ucd.ie
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