Abstract
Introduction: Delayed graft function (DGF) is associated with significant adverse outcomes
in deceased donor kidney transplantation (KT) including lower graft survival. However, risk
factors and potential preventive strategies like intraoperative rabbit antithymocyte globulin
(rATG; thymoglobulin) have not yet been fully evaluated.
Objectives: The aim of this study was to investigate DGF risk factors and determine the
association of intraoperative rATG with the risk of DGF in deceased donor kidney recipients.
Patients and Methods: We retrospectively examined medical records of 163 first time
deceased donor kidney transplant recipients at two major kidney transplant centers from 2014
to 2016. All the donors were standard heart-beating, brain death donors. Risk factors for DGF
in recipients were evaluated using multivariate logistic regression analysis.
Results: The mean recipients’ age was 43±13 years and the majority of participants were male
(64%). The overall rate of DGF was 27%. Intraoperative rATG was significantly associated
with a lower rate of DGF (adjusted odds ratio [AOR], 0.33, 95% CI, 0.11-0.95). Intraoperative
transfusion (AOR, 3.7, 95% CI, 1.4-9.9) and diabetes mellitus (AOR, 3.7, 95% CI, 1.5-8.9) were
significantly associated with higher risk of DGF.
Conclusion: This study showed that intraoperative blood transfusion and diabetes mellitus
were associated with increased risk of DGF. Meanwhile, administration of intraoperative
rATG was associated with reduced odds ratio of DGF. Future studies are needed to evaluate
the potential role of rATG in DGF-related renal outcomes.