Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders>>>>>Renal Transplantation
Question 4#

Delayed graft function (DGF) after renal transplant is most commonly defined as:

A. Dialysis requirement within 7 days of transplantation
B. Failure of decrease in serum creatinine after transplantation
C. Proteinuria >1 g/d
D. Urine output <0.5 mL/kg for 1 week

Correct Answer is A


Correct Answer: A

Although there are over 10 definitions of DGF in the literature, it is most commonly defined as the need for dialysis within 7 days of transplantation (69% of studies reviewed between 1984 and 2007 use this criteria for their definition). This definition offers a standard by which centers can report outcomes and define a clinical entity that can be studied to help improve graft and patient survival. It occurs in 20% to 50% of patients receiving a first cadaveric graft. It is characterized by acute tubular necrosis following renal transplantation. DGF occurs more commonly among recipients of deceased donor transplants compared with live donor transplants. DGF has significant effects on graft and patient survival as it can be associated with both acute and chronic allograft nephropathy and increased risk of graft failure. Risk factors include deceased donor and prolonged allograft ischemia times. Studies are currently ongoing to look at pretransplant, intraoperative, and posttransplant interventions that may reduce the risk of DGF and subsequent graft failure. These treatments focus on immunosuppression, ischemic preconditioning, and vasodilatory agents.


  1. Perico N, Cattaneo D, Sayegh MH, Remuzzi G. Delayed graft function in kidney transplantation. Lancet. 2004;364:1814-1827.
  2. Siedlecki A, Irish W, Brennan DC. Delayed graft function in the kidney transplant. Am J Transplant. 2011;11(11):2279-2296.