Delayed renal allograft function

Delayed renal allograft function

DGF is defined as the need for dialysis in the first 7 days post transplant. The patient will be oliguric or anuric and the serum creatinine will fail to fall in the early postoperative period. DGF is usually the clinical consequence of acute tubular necrosis related to ischaemia–reperfusion injury . It occurs in around 30% of DBD kidneys and 60% of DCD kidneys because of the significantly longer warm ischaemic period prior to organ cooling. In contrast, DGF occurs in <5% of live donor kidneys because of the short cold ischaemic time. An early Doppler ultrasound study should be performed in all patients with DGF to check that the graft is well vascularised. The management of DGF is supportive with haemodialysis, careful fluid balance and avoidance of CNI toxicity . Graft function usually recovers within a few days, but it may take several weeks. Primary non-function is the term used for grafts that never work. This occurs in <5% of renal transplants as a result of either vascular thrombosis or irreversible ischaemic injury leading to cortical necrosis.