Organ donor management goals and delayed graft function in adult kidney transplant recipients

Clin Transplant. 2022 Feb;36(2):e14528. doi: 10.1111/ctr.14528. Epub 2021 Nov 16.


Background: Delayed graft function (DGF) after kidney transplantation is a common occurrence and correlates with poor graft and patient outcomes. Donor characteristics and care are known to impact DGF. We attempted to show the relationship between achievement of specific donor management goals (DMG) and DGF.

Methods: This is a retrospective case-control study using data from 14 046 adult kidney donations after brain death from hospitals in 18 organ procurement organizations (OPOs) which were transplanted to adult recipients between 2012 and 2018. Data on DMG compliance and donor, recipient, and ischemia-related factors were used to create multivariable logistic regression models.

Results: The overall rate of DGF was 29.4%. Meeting DMGs for urine output and vasopressor use were associated with decreased risk of DGF. Sensitivity analyses performed with different imputation methods, omitting recipient factors, and analyzing multiple time points yielded largely consistent results.

Conclusions: The development of DMGs continues to show promise in improving outcomes in the kidney transplant recipient population. Studies have already shown increased kidney utilization in smaller cohorts, as well as other organs, and shown decreased rates of DGF. Additional research and analysis are required to assess interactions between meeting DMGs and correlation versus causality in DMGs and DGF.

Keywords: critical care; delayed graft function; donor management; kidney transplantation; tissue and organ procurement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Delayed Graft Function* / epidemiology
  • Delayed Graft Function* / etiology
  • Goals
  • Graft Survival
  • Humans
  • Kidney Transplantation* / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Tissue Donors