Delayed Graft Function in Kidney Transplant Overview

Kidney transplant is a critical, life-saving procedure for patients with end stage renal disease.  Kidney transplantation involves a surgical operation in which a person receives a new kidney from another person.  This procedure provides longer and better quality of life for transplant recipients and also provides cost savings as compared to the regular dialysis treatments that would otherwise be necessary. 

However, there is an ongoing severe shortage of kidneys available for transplantation.  There are approximately 100,000 patients waiting for a kidney transplant in the U.S., with approximately 35,000 patients being added to the waiting list each year.  In 2015 only approximately 18,000 transplants were performed, while approximately 4% of patients waiting for a kidney transplant die each year and an additional 4% become too sick to receive a kidney transplant.  This shortage of donated kidneys has led transplant centers to broaden their definition of acceptable organs, transplanting more kidneys from “extended criteria donors” (ECD) , with a higher risk of inferior outcome and impaired long-term graft survival.

Delayed Graft Function (DGF), where a transplanted kidney does not function as expected after surgery, is a major challenge in kidney transplantation.  DGF makes post-transplant management more difficult, leading to inferior short- and long-term graft (transplanted kidney) survival and patient survival as well as longer hospital stays and higher costs.  The incidence of DGF after transplantation can be as high as 55% in certain patient groups.  However, there is currently no approved therapy for DGF, which remains a serious unmet medical need in kidney transplantation patients. 

Kidney transplant has significant inflammatory and apoptotic components.  Inflammation and cell death are two of the main components of the ischemia/reperfusion injury associated with removing a non-functioning kidney and surgically inserting a different kidney.

Please see heme oxygenase in delayed graft function in kidney transplant for more information.

 

Delayed Graft Function in Kidney Transplant

 -  Where a transplanted kidney does not function as expected after surgery
 - Affects as many as 55% of patients in certain patient groups
 - Associated with inferior transplanted kidney and patient survival