Total ischemia time and delayed graft function in recipients of deceased donor kidney transplant: a single center experience

Objectives: Delayed graft function (DGF) is a well-known complication following kidney transplant. Ischemia time is one of several factors known to contribute to its development. The unique set up of the transplant service in Kuwait helps to achieve a shorter ischemia time than average compared to many other programs. We aim to study the association between the total ischemia time (TIT) and DGF, as well as other related common risk factors in this set up. Design: A single-center retrospective medical records review Setting: Kuwait Organ Transplant Center Subjects: All recipients of brain-dead deceased donor kidney transplant from January 2016 to December 2021 Intervention: No intervention Main outcome measures: The effect of TIT on developing DGF was studied, as well as other risk factors of DGF related recipients and donors. Results: A total of 180 kidney transplant recipients were included. DGF rate was 33% for the entire period with a significant decrease in the rate over the years, along with a significant decrease in the median TIT. Compared to TIT of less than 6 hours, increasing the time to 6-8 or 8-10 hours can result in over 3x the risk of DGF (P<0.05). Conclusions: Since DGF is a multi-factorial event, having a shorter TIT than average was not enough to result in a very low DGF rate. However, we demonstrated that even within the generally considered short ischemia times, to achieve shorter than 6 hours can potentially reduce DGF significantly.