Long-term outcomes among slow versus delayed or immediate graft function kidney transplant recipients: A single-center experience
Bajjoka I, Yaldo A, Crombez C, and Abouljoud M. Long-term outcomes among slow versus delayed or immediate graft function kidney transplant recipients: A single-center experience. Am J Transplant 2017; 17(suppl 3):563.
Am J Transplant
Purpose: To compare and evaluate short and long-term outcomes for kidney transplant recipients (KTR) with slow graft function (SGF) versus delayed (DGF) or immediate (IGF) graft function. Introduction: KTR who experience DGF exhibit worse outcomes than other KTR; however there is a subset of patients who do not require dialysis post-transplant, but have slower graft recovery. This novel analysis provides new data on outcomes for this sub-population. Methods: A single-center retrospective analysis of medical records of 352 KTR from 2012-2015 was performed. Study population was divided into three cohorts: IGF (n=174), SGF (n=83), and DGF (n=95). IGF is defined as KTR with a serum creatinine (SCr) <3mg/dL; SGF is defined as KTR with a SCr ≥3mg/dL at postoperative day (POD) 5; and DGF is defined as a KTR requiring dialysis within the first 7 POD. All African Americans (AA), KTR of ECD/DCD kidneys, repeat kidney transplants, and cPRA>20% received thymo induction. Demographics, 1yr biopsy-proven rejection (BPAR), as well as SCr and eGFR at point of last follow-up (FU) post-transplant were analyzed. Results: There was no overall statistical difference between the three groups' genders or ages. For other results, please refer to Table 1 (Table presented). DGF and SGF had a similar number of patients who received thymo induction (DGF, 64.21%; SGF, 67.47%; p>0.05), but both statistically higher than IGF (44.83%; p<0.05). In addition, DGF and SGF also had similar rates of BPAR at 1yr (DGF, 11.59%; SGF, 9.64%; p>0.05), but both statistically higher than IGF (8.05%; p<0.05). Conclusion: In our analysis, we found that the SGF patients behaved similarly to the DGF than the IGF population, long-term. Therefore, consideration must be made to these potentially high-risk patients.