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The relative influence of delayed graft function and acute rejection on renal transplant survival
Authors:M L Nicholson  T J Wheatley  T Horsburgh  C M Edwards  P S Veithc  P R F Bell
Institution:(1) University Department of Surgery, Leicester General Hospital, Gwendolen Road, LE5 4PW Leicester, UK
Abstract:Three hundred and eight cadaveric renal transplants were analysed to establish the effects of acute rejection in the first 90 days and delayed graft function (DGF) on graft outcome. There were 120 patients (39%) with no DGF and no rejection (group 1), 101 patients (33%) with rejection but no DGF (group 2), 41 patients (13%) with DGF but no rejection (group 3) and 46 patients (15%) with both rejection and DGF (group 4). The actuarial 4-year graft survival rates for groups 1,2,3 and 40.4%, respectively. The acute rejection rate was 101/221 (46%) in patients with initial graft function compared with 46/87 (53%) for those with DGF (chi2=1.02, P=0.31). Cox stepwise logistic regression analysis demonstrated that DGF was a more powerful predictive factor for poor graft survival (P=0.001) than acute rejection occurring in the first 90 days post-transplant (P=0.034). Further efforts at improving graft outcome should concentrate on reducing the incidence of DGF.
Keywords:Delayed graft function  graft survival  kidney  Graft survival  kidney  delayed graft function  Kidney graft survival  delayed graft function
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