Ten-Year Outcomes of Early Suboptimal Graft Function Following Deceased Donor Kidney Transplantation.

BACKGROUND: Early graft function is a critical predictor of long-term outcomes in kidney transplantation. This study evaluated 10-year outcomes in patients with suboptimal graft function (SGF) during the first month after deceased donor kidney transplantation (DDKT). METHODS: In this retrospective study of 294 adult DDKT recipients (February 2006-January 2014), SGF was defined as the lowest serum creatinine >1.5 mg/dL during the first month. Cases with a creatinine ≤1.5 mg/dL were categorized as the standard outcome group. Primary outcomes were 10-year graft and patient survival. RESULTS: Suboptimal graft function was associated with significantly poorer long-term graft survival (5-year: 82.3% vs 92.7%; 10-year: 63.2% vs 89.1%). Overall mortality did not differ between groups. Delayed graft function alone showed no significant association with graft survival. Donor age ≥ 60 years was also associated with inferior graft survival. CONCLUSION: Suboptimal early creatinine elevation is a significant predictor of long-term graft outcomes. Donor age is an important determinant of long-term graft outcomes.