Kidney Week 2025 Early Program - Care of Kidney Transplant Candidates and Recipients-Early Graft Dysfunction and Delayed Graft Function

Video Transcription

Video Summary

Dr. Harini Chikara reviews early graft dysfunction and delayed graft function (DGF), defining DGF as any dialysis within 7 days post–kidney transplant. Causes span a continuum: recipient factors (vascular/ureteral complications, hypotension, recurrent disease), donor factors (marginal kidneys, ischemia-reperfusion injury, long cold ischemia), and immunologic causes (early rejection). Workup includes biopsy review, hemodynamic monitoring, ultrasound, urinalysis, protein/creatinine ratios, and immunologic testing. She argues marginal kidneys (DCD, KDPI>85%, AKI kidneys) increase DGF rates but often have similar 1-year function and can improve older recipients’ survival. Outcomes worsen when DGF persists >14 days; DGF increases rejection risk. Mayo uses a standardized outpatient DGF workflow.

Asset Subtitle

Harini Chakkera

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Speaker Harini Chakkera

Keywords

delayed graft function (DGF)

kidney transplant early graft dysfunction

ischemia-reperfusion injury and cold ischemia time

marginal donor kidneys (DCD, KDPI>85%, AKI)

DGF workup and management workflow (biopsy, ultrasound, immunologic testing)