Delayed graft function in the kidney transplant

Am J Transplant. 2011 Nov;11(11):2279-96. doi: 10.1111/j.1600-6143.2011.03754.x. Epub 2011 Sep 19.

Abstract

Acute kidney injury occurs with kidney transplantation and too frequently progresses to the clinical diagnosis of delayed graft function (DGF). Poor kidney function in the first week of graft life is detrimental to the longevity of the allograft. Challenges to understand the root cause of DGF include several pathologic contributors derived from the donor (ischemic injury, inflammatory signaling) and recipient (reperfusion injury, the innate immune response and the adaptive immune response). Progressive demand for renal allografts has generated new organ categories that continue to carry high risk for DGF for deceased donor organ transplantation. New therapies seek to subdue the inflammatory response in organs with high likelihood to benefit from intervention. Future success in suppressing the development of DGF will require a concerted effort to anticipate and treat tissue injury throughout the arc of the transplantation process.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Brain Death / physiopathology
  • Delayed Graft Function / prevention & control*
  • Delayed Graft Function / therapy
  • Graft Survival / physiology
  • Humans
  • Immunosuppression / methods
  • Ischemic Preconditioning / methods
  • Kidney Transplantation / immunology
  • Kidney Transplantation / physiology*
  • Organ Preservation / methods
  • Perfusion / methods
  • Reperfusion Injury / complications
  • Reperfusion Injury / immunology
  • Risk Factors
  • Thrombosis / prevention & control
  • Tissue Donors
  • Warm Ischemia / adverse effects

Substances

  • Anticoagulants