Impact of delayed graft function on overall and graft survival in recipients of deceased donor kidney transplants

Delayed graft function (DGF) is a frequent complication among recipients of deceased donor kidney transplants, with an incidence rate ranging from 20% to 50%. This study aimed to evaluate the impact of DGF on both graft and overall patient survival. In a retrospective cohort of 293 patients who underwent transplantation between 2007 and 2021, demographic, clinical, and long-term follow-up data were analyzed. Patients with DGF had a significantly lower 5-year graft survival rate than did those without DGF (log-rank test: p = 0.004; DGF: 80.0%, 95% CI: 70.0% − 91.0% vs. no DGF: 92.0%, 95% CI: 89.2% − 95.9%); nevertheless, without significant differences over 10 years (log-rank test: p = 0.098; DGF: 80.0%, 95% CI: 70.0% − 91.0% vs. no DGF: 87.9%, 95% CI: 83.8% − 92.1%). Regarding the overall survival, no significant differences were observed over 5 years (log-rank test: p = 0.9; DGF: 92.7%, 95% CI: 86.1% − 99.0% vs. no DGF: 92.0%, 95% CI: 89%-96%) or at 10 years (log-rank test: p = 0.81; DGF: 89.1%, 95% CI: 81.2%-97.7% vs. no DGF: 87.9%, 95% CI: 83.8%-92.1%). Multivariate analysis indicated that DGF was not associated with an increased risk of graft loss or reduced recipient survival. These findings underscore the need for larger, prospective studies to further elucidate the long-term implications of DGF and outline clinical management strategies for kidney transplant recipients.