Early Function as the Principal Correlate of Graft Survival. A Multivariate Analysis of 200 Cadaveric Renal Transplants Treated with a Protocol Incorporating Antilymphocyte Globulin and Cyclosporine

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“…[1][2][3][4][5][6][9][10][11][12][13][14][15][16][17] The average cost of initial hospitalization for patients undergoing deceased donor renal transplant, who develop DGF, is approximately $25 000 higher per patient. [17][18][19][20][24][25][26][27][28] When the clinical manifestations of DGF, such as increased rate of acute rejection and worse graft survival, are taken into account, the economic impact is expanded. 19,20,27 Delayed graft function is thus associated with lower graft survival, longer hospital stay, higher costs, and increased psychologic and significant medical sequelae.…”

“…[17][18][19][20][24][25][26][27][28] When the clinical manifestations of DGF, such as increased rate of acute rejection and worse graft survival, are taken into account, the economic impact is expanded. 19,20,27 Delayed graft function is thus associated with lower graft survival, longer hospital stay, higher costs, and increased psychologic and significant medical sequelae. [17][18][19][20][21][24][25][26][27][28][29][30] In patients with DGF, hemodialysis itself is an additional oxidative stress.…”

“…19,20,27 Delayed graft function is thus associated with lower graft survival, longer hospital stay, higher costs, and increased psychologic and significant medical sequelae. [17][18][19][20][21][24][25][26][27][28][29][30] In patients with DGF, hemodialysis itself is an additional oxidative stress. The need for even 1 dialysis session posttransplant creates a milieu that affects B and T cells, which can lead to impaired wound healing and/or wound breakdown.…”

Ischaemia Reperfusion Injury in Kidney Transplantation

“…The inflammatory state incited during IRI enhances the immunogenicity of the graft leading to an increased incidence of rejection. The independent association between delayed graft function and graft loss has long been recognised and its influence is more pronounced with concomitant rejection (Halloran, Aprile et al 1988;Shoskes and Cecka 1998).…”

The Impact of Ischemia and Reperfusion Injury in Kidney Allograft Outcome

“…Delayed graft function (DGF) is defined by transplant centers as: the need of dialysis (at least one session) during the first week post-transplantation (Koning et al, 1997), early urine output lower than 1200mL/day or no decrease in serum creatinine within 48h (Shoskes et al, 2001), creatinine clearance lower than 10mL/min (Giral-Classe et al, 1998), creatinine at day 10 higher than 221µmol/L (Cosio et al, 1997). Delayed graft function has been considered an independent predictor of graft loss since multivariate analysis showed a relative risk of graft loss 2.9 times greater for DGF than for kidneys with immediate function (Halloran et al, 1988). The US Renal Data System (37,000 primary cadaver transplants) showed a relative risk of 1.53 for 5-year graft loss in association with DGF (Ojo et al, 1997).…”