Factors predicting kidney delayed graft function among recipients of simultaneous liver-kidney transplantation: A single-center experience

Islam M. Korayem, Vatche G. Agopian, Keri E. Lunsford, Hans A. Gritsch, Jeffrey L. Veale, Gerald S. Lipshutz, Hasan Yersiz, Coney L. Serrone, Fady M. Kaldas, Douglas G. Farmer, Suphamai Bunnapradist, Gabriel M. Danovitch, Ronald W. Busuttil, Ali Zarrinpar

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Kidney delayed graft function (kDGF) remains a challenging problem following simultaneous liver and kidney transplantation (SLKT) with a reported incidence up to 40%. Given the scarcity of renal allografts, it is crucial to minimize the development of kDGF among SLKT recipients to improve patient and graft outcomes. We sought to assess the role of preoperative recipient and donor/graft factors on developing kDGF among recipients of SLKT. Methods: A retrospective review of 194 patients who received SLKT in the period from January 2004 to March 2017 in a single center was performed to assess the effect of preoperative factors on the development of kDGF. Results: Kidney delayed graft function was observed in 95 patients (49%). Multivariate analysis revealed that donor history of hypertension, cold static preservation of kidney grafts [versus using hypothermic pulsatile machine perfusion (HPMP)], donor final creatinine, physiologic MELD, and duration of delay of kidney transplantation after liver transplantation were significant independent predictors for kDGF. kDGF is associated with worse graft function and patient and graft survival. Conclusions: Kidney delayed graft function has detrimental effects on graft function and graft survival. Understanding the risks and combining careful perioperative patient management, proper recipient selection and donor matching, and graft preservation using HPMP would decrease kDGF among SLKT recipients.

Original languageEnglish (US)
Article numbere13569
JournalClinical Transplantation
Volume33
Issue number6
DOIs
StatePublished - Jun 2019

Keywords

  • delayed graft function (DGF)
  • dysfunction
  • kidney (allograft) function
  • organ perfusion and preservation

ASJC Scopus subject areas

  • Transplantation

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