The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes

Delayed graft function (DGF), is associated with inferior graft outcomes. Whether poor graft function without dialysis, termed slow graft function (SGF), affects outcomes is unclear. We investigated associations between SGF (serum creatinine dropping by less than 30% between days 1 and 2), DGF and g...

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Main Authors: Karthik Venkataraman, Georgina L. Irish, Michael G. Collins, Philip A. Clayton
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Transplant International
Subjects:
Online Access:https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14197/full
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author Karthik Venkataraman
Karthik Venkataraman
Karthik Venkataraman
Georgina L. Irish
Georgina L. Irish
Georgina L. Irish
Michael G. Collins
Michael G. Collins
Michael G. Collins
Philip A. Clayton
Philip A. Clayton
Philip A. Clayton
author_facet Karthik Venkataraman
Karthik Venkataraman
Karthik Venkataraman
Georgina L. Irish
Georgina L. Irish
Georgina L. Irish
Michael G. Collins
Michael G. Collins
Michael G. Collins
Philip A. Clayton
Philip A. Clayton
Philip A. Clayton
author_sort Karthik Venkataraman
collection DOAJ
description Delayed graft function (DGF), is associated with inferior graft outcomes. Whether poor graft function without dialysis, termed slow graft function (SGF), affects outcomes is unclear. We investigated associations between SGF (serum creatinine dropping by less than 30% between days 1 and 2), DGF and graft outcomes by donor type in a cohort of 17,579 Australian and New Zealand kidney transplant recipients from 2001–2021. The primary outcomes were graft survival and death-censored graft survival Compared with immediate graft function, both SGF (Adjusted hazard ratio [aHR] 1.48 (95% CI 1.14–1.91) and DGF [aHR 1.97 (1.42–2.73)] were associated with reduced graft survival in living donor and donation after brain death (DBD) recipients [SGF aHR 1.13 (1.01–1.27); DGF aHR 1.37 (1.24–1.51)]. In donation after circulatory death (DCD) recipients, DGF [(aHR 1.52 (1.13–2.04)] but not SGF [(aHR 1.55 (1.13–2.13)] was associated with reduced graft survival. Findings were similar for death-censored graft survival. In secondary analyses, SGFwas associated with reduced patient survival in living donor recipients. SGF and DGF were associated with lower 12-month eGFR for all donor types. DGF increased the odds of rejection for all donor types; for SGF this association was significant only for DBD recipients. SGF is associated with adverse outcomes in live donor and DBD kidney recipients.
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spelling doaj-art-1f1f3e56ffbf44c09beaca73771c39262025-08-20T03:10:11ZengFrontiers Media S.A.Transplant International1432-22772025-05-013810.3389/ti.2025.1419714197The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant OutcomesKarthik Venkataraman0Karthik Venkataraman1Karthik Venkataraman2Georgina L. Irish3Georgina L. Irish4Georgina L. Irish5Michael G. Collins6Michael G. Collins7Michael G. Collins8Philip A. Clayton9Philip A. Clayton10Philip A. Clayton11Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, AustraliaCentral and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, AustraliaTransplant Epidemiology Group (TrEG), Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, AustraliaFaculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, AustraliaCentral and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, AustraliaTransplant Epidemiology Group (TrEG), Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, AustraliaFaculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, AustraliaCentral and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, AustraliaTransplant Epidemiology Group (TrEG), Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, AustraliaFaculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, AustraliaCentral and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, AustraliaTransplant Epidemiology Group (TrEG), Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, AustraliaDelayed graft function (DGF), is associated with inferior graft outcomes. Whether poor graft function without dialysis, termed slow graft function (SGF), affects outcomes is unclear. We investigated associations between SGF (serum creatinine dropping by less than 30% between days 1 and 2), DGF and graft outcomes by donor type in a cohort of 17,579 Australian and New Zealand kidney transplant recipients from 2001–2021. The primary outcomes were graft survival and death-censored graft survival Compared with immediate graft function, both SGF (Adjusted hazard ratio [aHR] 1.48 (95% CI 1.14–1.91) and DGF [aHR 1.97 (1.42–2.73)] were associated with reduced graft survival in living donor and donation after brain death (DBD) recipients [SGF aHR 1.13 (1.01–1.27); DGF aHR 1.37 (1.24–1.51)]. In donation after circulatory death (DCD) recipients, DGF [(aHR 1.52 (1.13–2.04)] but not SGF [(aHR 1.55 (1.13–2.13)] was associated with reduced graft survival. Findings were similar for death-censored graft survival. In secondary analyses, SGFwas associated with reduced patient survival in living donor recipients. SGF and DGF were associated with lower 12-month eGFR for all donor types. DGF increased the odds of rejection for all donor types; for SGF this association was significant only for DBD recipients. SGF is associated with adverse outcomes in live donor and DBD kidney recipients.https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14197/fullgraft functionkidney transplantANZDATAgraft survivaldelayed graft function (DGF)
spellingShingle Karthik Venkataraman
Karthik Venkataraman
Karthik Venkataraman
Georgina L. Irish
Georgina L. Irish
Georgina L. Irish
Michael G. Collins
Michael G. Collins
Michael G. Collins
Philip A. Clayton
Philip A. Clayton
Philip A. Clayton
The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes
Transplant International
graft function
kidney transplant
ANZDATA
graft survival
delayed graft function (DGF)
title The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes
title_full The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes
title_fullStr The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes
title_full_unstemmed The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes
title_short The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes
title_sort association between early graft function donor type and long term kidney transplant outcomes
topic graft function
kidney transplant
ANZDATA
graft survival
delayed graft function (DGF)
url https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14197/full
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