Department of Surgery, Division of Transplantation, Medical College of Wisconsin, Milwaukee, WI.
Centura Transplant, Denver, Colorado.
Am J Kidney Dis. 2024 Mar;83(3):360-369. doi: 10.1053/j.ajkd.2023.08.018. Epub 2023 Oct 14.
Delayed graft function (DGF) is a common complication after kidney transplant. Despite extensive literature on the topic, the extant definition of DGF has not been conducive to advancing the scientific understanding of the influences and mechanisms contributing to its onset, duration, resolution, or long-term prognostic implications. In 2022, the National Kidney Foundation sponsored a multidisciplinary scientific workshop to comprehensively review the current state of knowledge about the diagnosis, therapy, and management of DGF and conducted a survey of relevant stakeholders on topics of clinical and regulatory interest. In this Special Report, we propose and defend a novel taxonomy for the clinical and research definitions of DGF, address key regulatory and clinical practice issues surrounding DGF, review the current state of therapies to reduce and/or attenuate DGF, offer considerations for clinical practice related to the outpatient management of DGF, and outline a prospective research and policy agenda.
延迟移植物功能(DGF)是肾移植后的一种常见并发症。尽管有大量关于该主题的文献,但现存的 DGF 定义不利于深入了解导致其发生、持续时间、解决或长期预后影响的因素和机制。2022 年,美国国家肾脏基金会(National Kidney Foundation)赞助了一次多学科科学研讨会,全面审查了关于 DGF 的诊断、治疗和管理的现有知识状况,并对相关利益攸关方进行了与临床和监管相关的主题的调查。在本特别报告中,我们提出并捍卫了 DGF 的临床和研究定义的新分类法,讨论了 DGF 周围的关键监管和临床实践问题,审查了减少和/或减轻 DGF 的现有治疗方法,为与 DGF 门诊管理相关的临床实践提供了一些考虑,并概述了一个前瞻性的研究和政策议程。