Significance of delayed graft function in cyclosporine-treated recipients of cadaver kidney transplants

John Barry, N. Shively, B. Hubert, T. Hefty, Douglas Norman, W. M. Bennett

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Abstract

Many transplant teams are reluctant to initiate cyclosporine immunosuppression in recipients of cadaver kidney grafts with delayed graft function (DGF). The renal function of cadaver kidney grafts in cyclosporine-treated recipients was compared in 47 recipients with DGF and 57 without DGF. Regardless of initial renal function, all recipients received prednisone, azathioprine, and oral cyclosporine 5 mg/kg/day or its intravenous equivalent. All kidneys were flushed with icecold intracellular electrolyte solution and cold-stored for 15-54 hr (mean of 31 hr) prior to transplantation at our hospital between April 10, 1985 and November 30, 1986. Rejection crises were treated with high-dose steroids or OKT3. Cyclosporine was discontinued during courses of OKT3. Recipients with DGF had significantly higher one-month serum creatinine nadirs (2.6 ± 1.8 mg/dl. vs. 1.5 ± 0.5 mg/dl). Actuarial graft survivals were not significantly different at one year (82.2 ± 5.5% vs. 82.6 ± 6.4%, all graft losses included). Mean serum creatinine levels at six months and twelve months after grafting were not significantly different (1.7 ± 0.4 mg/dl vs. 1.8 ± 1.2 mg/dl and 2.0 ± 0.5 vs. 1.7 ± 0.7 mg/dl, respectively). Delayed graft function following cadaver kidney transplantation does not adversely affect intermediate term function of kidney grafts flushed with intracellular electrolyte solution and cold-stored until transplantation when a low-dose cyclosporine induction protocol is used and cyclosporine is discontinued during OKT3 administration.

Original languageEnglish (US)
Pages (from-to)346-348
Number of pages3
JournalTransplantation
Volume45
Issue number2
Publication statusPublished - 1988

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ASJC Scopus subject areas

  • Immunology
  • Transplantation

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