Division of Nephrology, Department of Pediatrics, University of Pittsburgh, UPMC Children's Hospital, Pittsburgh, Pennsylvania, United States.
Am J Physiol Renal Physiol. 2023 Dec 1;325(6):F817-F825. doi: 10.1152/ajprenal.00146.2023. Epub 2023 Oct 19.
The incidence of end-stage renal disease (ESRD) has been increasing worldwide. Its treatment involves renal replacement therapy, either by dialyses or renal transplantation from a living or deceased donor. Although the initial mortality rates for patients on dialysis are comparable with kidney transplant recipients, the quality of life and long-term prognosis are greatly improved in transplanted patients. However, there is a large gap between availability and need for donor kidneys. This has led to the increase in the use of expanded kidney donor criteria. Allograft dysfunction immediately after transplant sets it up for many complications, such as acute rejection and shorter allograft survival. Delayed graft function (DGF) is one of the immediate posttransplant insults to the kidney allograft, which is increasing in prevalence due to efforts to maximize the available donor pool for kidneys and use of expanded kidney donor criteria. In this review, we discuss the risk factors for DGF, its implications for long-term allograft survival, animal models of DGF, and the therapeutic options currently under evaluation for prevention and management of DGF.
终末期肾病（ESRD）的发病率在全球范围内不断上升。其治疗方法包括肾脏替代疗法，通过透析或来自活体或已故供体的肾移植。尽管透析患者的初始死亡率与肾移植受者相当，但移植患者的生活质量和长期预后得到了极大改善。然而，供体肾脏的可获得性与需求之间存在巨大差距。这导致扩大了肾脏供体标准的使用。移植后移植物功能障碍立即导致许多并发症，如急性排斥反应和移植物存活时间缩短。延迟性移植物功能障碍（DGF）是移植后肾脏移植物的即刻损伤之一，由于努力使可供肾脏使用的供体库最大化并扩大肾脏供体标准，其患病率不断增加。在这篇综述中，我们讨论了 DGF 的危险因素、其对长期移植物存活的影响、DGF 的动物模型，以及目前正在评估的用于预防和治疗 DGF 的治疗选择。
