Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Clin Transplant. 2022 Sep;36(9):e14779. doi: 10.1111/ctr.14779. Epub 2022 Jul 27.
Delayed graft function (DGF) is a common complication among deceased donor kidney transplant recipients (DDKTs) and is associated with worse outcomes. The effect on outcomes of concordance versus discordance in DGF between two different recipients of kidneys from the same donor is largely unknown.
We reviewed all adult DDKTs for which both kidneys were transplanted to two different recipients at our center between 2014-2019. DDKTs were divided into four groups based on the DGF status: concordance no DGF (cc-no-DGF); discordance no DGF(dd-no-DGF); discordance DGF (dd-DGF) and concordance in DGF (cc-DGF). Acute rejection (AR) and death censored graft failure (DCGF) were outcomes of interest.
A total of 578 DDKTs fulfilled our selection criteria, 280were in cc-no-DGF, 83 in dd-no-DGF, 83 in dd-DGF, and 132 in cc-DGF. Compared to cc-no-DGF, in univariate analysis, dd-DGF was associated with an increased risk of AR (HR: 1.60; 95% CI: 1.0-2.56) but cc-DGF was not (HR: 1.01; 95% CI: 0.63-1.62). dd-DGF was not associated with an increased risk of AR in multivariate analysis. In multivariate analysis, dd-DGF was associated with an increased risk of DCGF (HR: 2.70; 95% CI: 1.05-6.93) but cc-DGFwas not (HR: 2.36; 95% CI: 0.97-5.70).
Discordance in DGF is associated with worse outcomes and may need closefollow-up and monitoring to improve the outcomes.
延迟移植物功能（DGF）是尸体供肾移植受者（DDKT）的常见并发症，与更差的结果相关。同一供体的两个不同受者之间 DGF 一致性与不一致性对结果的影响在很大程度上尚不清楚。
我们回顾了 2014 年至 2019 年间在我们中心接受两个不同受者移植的所有成人 DDKT。根据 DGF 状态，DDKT 分为四组：一致性无 DGF（cc-no-DGF）；不一致性无 DGF（dd-no-DGF）；不一致性 DGF（dd-DGF）和一致性 DGF（cc-DGF）。急性排斥反应（AR）和死亡censored 移植物衰竭（DCGF）是感兴趣的结果。
共有 578 例 DDKT 符合我们的选择标准，280 例为 cc-no-DGF，83 例为 dd-no-DGF，83 例为 dd-DGF，132 例为 cc-DGF。与 cc-no-DGF 相比，在单变量分析中，dd-DGF 与 AR 风险增加相关（HR：1.60；95%CI：1.0-2.56），但 cc-DGF 则不然（HR：1.01；95%CI：0.63-1.62）。dd-DGF 在多变量分析中与 AR 风险增加无关。在多变量分析中，dd-DGF 与 DCGF 风险增加相关（HR：2.70；95%CI：1.05-6.93），但 cc-DGF 则不然（HR：2.36；95%CI：0.97-5.70）。
DGF 不一致与较差的结果相关，可能需要密切随访和监测以改善结果。
