Delayed graft function may not adversely affect short-term renal allograft outcome

: Introduction: Delayed graft function (DGF) is commonly believed to adversely impact both short‐ and long‐term renal allograft function. Because immunosuppressive therapy is commonly altered after DGF is identified, retrospective analyses are difficult to interpret. We therefore prospectively sough...

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Bibliographic Details
Published in:Clinical transplantation 2003-01, Vol.17 (s9), p.35-38
Main Authors: Browne, Barry J, Holt, Cynthia Op't, Emovon, Osemwegie E
Format: Article
Language:English
Subjects:
Adult
Clinical Protocols
delayed graft function
Female
Graft Survival - physiology
Humans
immunosuppression
Immunosuppressive Agents - pharmacology
kidney transplant
Kidney Transplantation - adverse effects
Kidney Transplantation - physiology
Male
Middle Aged
Prospective Studies
Recovery of Function - drug effects
Recovery of Function - physiology
Time Factors
Transplants - adverse effects
Treatment Outcome
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Summary:: Introduction: Delayed graft function (DGF) is commonly believed to adversely impact both short‐ and long‐term renal allograft function. Because immunosuppressive therapy is commonly altered after DGF is identified, retrospective analyses are difficult to interpret. We therefore prospectively sought to examine the natural history of DGF in a controlled patient population under identical immunosuppressive protocols. Methods: Adult patients undergoing cadaveric renal transplantation were treated with sequential triple drug immunotherapy. High‐dose steroids were administered in the operating room and rapidly tapered to 20 mg prednisone by post‐operative day (POD) 6. Cyclosporine (CsA) microemulsion was begun on POD 1, and dosed asymmetrically at 12‐h intervals to reach a daytime Cav of 650 ng/mL (utilizing 2‐h and 6‐h levels), while PM doses were adjusted to an AM trough of 300 ng/mL. Mycophenolate (1000 mg q12 h) was added on POD 3 in most patients and discontinued after 3 months. No induction agents were used. All patients were followed for at least 6 months. Results: Sixty consecutive patients received 64 allografts (four double grafts). In all, 17 patients required dialysis and were considered to have DGF. Eight of these patients received marginal organs turned down by at least one other centre. Cold ischaemia time was significantly longer in patients with DGF (24 h vs. 19 h, P 
ISSN:0902-0063
1399-0012
DOI:10.1034/j.1399-0012.17.s9.6.x