DELETERIOUS EFFECTS OF DELAYED GRAFT FUNCTION IN CADAVERIC RENAL TRANSPLANT RECIPIENTS INDEPENDENT OF ACUTE REJECTION1,2,3

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Abstract
In cadaveric renal transplantation, delayed graft function (DGF) correlates with poor long-term graft survival; however, whether its effects are independent of acute rejection is controversial. We wished to study the effect of DGF on graft survival, controlling for acute rejection, discharge creatinine, and human leukocyte antigen match. We analyzed 27,096 first cadaveric donor renal transplant report to the UNOS Scientific Renal Transplant Registry between January 1994 and November 1997. DGF was defined as dialysis need in the first week. Acute rejection was recorded for initial hospitalization and within 6 months. Kaplan Meier survival curves were analyzed with the log rank test. DGF increased the incidence of acute rejection before discharge (8% without DGF; 25% with DGF, PP DGF is an important independent predictor of poor graft survival. Never immunosuppressive strategies must minimize nonimmune and immune renal injury if long-term graft survival is to improve.