One-Year Follow-Up of Delayed Graft Function in Renal Transplant Patients Performed in Private Hospitals in the State of México, México

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Background: Renal graft function delay (GFD) is defined as the need for dialysis in the first week after kidney transplantation (KT). The most common cause is acute post-ischemia tubular necrosis (ATN-pi). The survival reported in the literature of kidney grafts (KG) after one year with ATN-pi is about 89% for CDKT and 95% for LDKT. We report the evolution of KT made from May 1994 to December 2019 in two private hospitals in the City of Toluca, State of Mexico. Methods: The data were obtained from the clinical records and were analyzed with student t-test and Chi2 for continuous or categorical variables respectively. The results are expressed as means with standard deviation, accepted as significant value of p <0.05. SPSS 11.5 statistical program was used. Results: We perform 28 KT: Male 19 (68%), Female 9 (32%). Age 36.5±14.89 years old (yo). Haemodialysis Pre-KT 22 (78.6%), CAPD pre-KT 6 (21.4%). Cause of CKD: Unknown 19 (68%), Diabetic Nephropathy 5 (17.9%), Others 4 (14.2%). LDKT 13 (46.4%), CDKT 15 (53.6%). The ATN-pi showed up 11 (39.3%), of these 10 with DCKT (90.9%) and 1 LDKT (9.1%). 0 HLA 23 (82.1%), 1 HLA 5 (17.9%). Evolution post-KT RG function (with SCr mg/dl): SCr one week post-KT ATN-pi 3.9±1.98 vs No ATN-pi 1.48±0.5 (p 0.0001). SCr one month post-KT ATN-pi 1.47±0.27 vs No ATN-pi 1.18±0.35 (p 0.02). SCr Three months Post-KT ATN-pi 1.25±0.3 vs No ATN-pi 1.13±0.26 (p NS). SCr six months post-KT ATN-pi 1.18±0.18 vs No ATN-pi 1.18±0.3 (p NS). SCr twelve months post-KT ATN-pi 1.25±0.16 vs No ATN-pi 1.18±0.24 (p NS). RG working one year after KT was 28 (100%). Risk factors associated with the development of ATN-pi: Male 10/11 with ATN-pi vs 12/13 No ATN-pi (p 0.03) (RR 8.8). DCKT 10 with ATN-pi vs 5 No ATN-pi (p 0.001) (RR 24). Receptor age; KT ATN-pi 43.9±12.73 yo vs No ATN-pi 32.11±14.97 yo (p 0.03). Diabetic Nephropathy ATN-pi 4 vs No ATN-pi 1 (p 0.04) (RR 9.1). Cold ischemia time with ATN-pi 14.7±4.9 hours vs No ATN-pi 5.7±8.4 hours (p 0.001). No other risk factors were found. Conclusions: In our study sample, the incidence of Renal Graft function delay was 39.3%. ATN-pi was the only cause of GFD. The patient's survival and renal graft to a follow-up year was 100%.

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