Long-term Outcomes of Kidney Transplant Recipients with Delayed Graft Function: A Single-center Experience

Long-term Outcomes After Delayed Graft Function

Abstract

Objective: Delayed graft function (DGF), defined as the need for dialysis within the first week after transplantation, is a common early complication after deceased donor kidney transplantation. Although it is associated with adverse short-term outcomes, its long-term impact remains uncertain. We evaluated long-term patient and graft outcomes among deceased donor kidney transplant recipients who developed DGF.
Methods: This retrospective study identified 92 adult recipients of first deceased donor kidney transplants, of whom 79 developed DGF and constituted the primary analytic cohort. DGF was defined as dialysis requirement within 7 days post-transplant. Rejection, infections, graft loss, mortality, and long-term survival were analyzed among the 79 recipients who developed DGF.
Results: DGF occurred in 79 of 92 recipients (85.9%). Median follow-up was 113 months. Among the 79 recipients with DGF, six acute rejection episodes were observed, including two antibody-mediated cases; all rejection episodes received treatment according to the type of rejection. Among the 79 recipients with DGF, five viral infections were documented (BK virus n = 3, cytomegalovirus n = 1, parvovirus n = 1). During follow-up, 22 graft losses and 13 deaths occurred. Patient survival at 1, 3, 5, and 10 years was 100%, 97%, 93%, and 89%, respectively. Death-censored graft survival rates were 100%, 97%, 93%, and 86%, respectively.
Conclusion: In this cohort of deceased donor kidney transplant recipients who developed DGF, favorable long-term patient and graft outcomes were observed. These findings suggest that favorable long-term outcomes may be achieved among recipients who develop DGF when appropriate post-transplant management is provided. The occurrence of viral infections highlights the need for close monitoring and individualized immunosuppressive strategies.