Delayed Graft Function After Kidney Transplantation

Abstract

Introduction: Delayed graft function (DGF) complicates 20–50% of deceased donor kidney transplants and affects long-term outcomes. Methods: Systematic review of risk factors, prevention, and management strategies from 50 studies (2000–2024). Results: Key risk factors include donor age >50 years, cold ischemia time >24 hours, and recipient obesity. Hypothermic machine perfusion reduced DGF by 25% compared to static cold storage. Therapeutic hypothermia in donors lowered DGF incidence by 30%. Discussion: DGF increases acute rejection risk by 2-fold and reduces 5-year graft survival by 15%. Early dialysis and avoiding calcineurin inhibitors until recovery are standard. Conclusion: Optimizing donor management and machine perfusion are effective preventive strategies.