Perico et al listed risk factors associated with delayed graft function after renal transplantation.


There are several different criteria to define delayed graft function, but a commonly used one is the need for dialysis during the first week after the transplantation.



(1) donor factors

(2) allograft handling

(3) recipient factors


Donor factors:

(1) age > 55 years of age

(2) marginal renal function secondary to diabetes, hypertension, or other disease

(3) heart not beating at time of harvesting

(4) need for inotropic support


Allograft handling:

(1) cold storage preservation

(2) extended cold ischemia time


Recipient factors:

(1) hypovolemia

(2) perioperative hypotension

(3) intra-operative albumin administration

(4) hemodialysis with ultrafiltration within 24 hours of transplant procedure

(5) hemodialysis at night prior to the transplant

(6) history of previous renal transplant

(7) vascular thrombosis secondary to a hypercoagulable state (Factor V Leiden, antiphospholipid antibody, etc.)

(8) treatment with OKT3 monoclonal antibody

(9) presence of preformed antibodies to donor antigens

(10) acute tubular necrosis

(11) cyclosporine nephrotoxicity

(12) ureteral leakage after the transplant

(13) postrenal obstruction


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