Delayed graft function: Risk factors, consequences and parameters affecting outcome—results from MOST, A Multinational Observational Study
2005
Abstract Background Delayed graft function (DGF) is a common complication after renal
transplantation, and may affect graft function. The aim of this analysis was to evaluate risk
factors for DGF, as well as parameters and events influencing graft function after DGF. We
analyzed data collected in an ongoing international, prospective; observational study, the
Neoral-MOST (Multinational Observational Study in renal Transplantation), and included in
the analysis all patients with cadaveric kidney transplants for whom renal function at 1 year
posttransplantation was documented ( N = 8950). Logistic regression was used to evaluate
the risk factors for DGF occurrence, and multifactorial analysis of variance (ANCOVA) to
assess the relevance of different factors for GFR at 1 year. Results Higher donor age, longer CIT, male recipients, Caucasian recipients, high
recipients body mass index, and PRA were all associated with a higher risk for DGF. Renal function of former
DGF kidneys at 1 year was lower in kidneys of elder donors, or which had experienced
rejection or CMV infection. Variations of the maintenance regimen at 1 year posttransplantation
were not associated with better graft function. Multifactorial analysis showed
donor age and acute rejection as significant independent factors. Conclusions Most factors increasing the risk for DGF or having a negative impact on
renal function at 1 year in grafts with DGF are predetermined. Additional posttransplant
damage by acute rejection was associated with further reductions in GFR. Preventing acute rejection is
an important step in achieving optimal function of DGF grafts.
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