Incidence of Delayed Graft Function in Cadaveric Kidney Transplants in Brazil: A Multicenter Analysis L.S. Azevedo, M.C.R. Castro, D.B. Monteiro de Carvalho, D.O. d’Avila, F. Contieri, R.T. Gonçalves, R. Manfro, and L.E. Ianhez ABSTRACT To evaluate the frequency of delayed graft function (DGF) in kidney transplant centers in Brazil, we sent a questionnaire requesting information on the number of cadaveric donor kidney transplants performed during the years 2000, 2001, and 2002, the number of early nonfunctioning grafts, and the number of patients on dialysis during the first posttransplant week with subsequent recovery. Among all centers performing more than 50 kidney trans- plants during the last year of evaluation, 6, performing 612 cadaveric kidney transplants during the study period, replied to the questionnaire. Sixty procedures (9.7%) resulted in nonfunc- tioning grafts, while 312 (55.6%) patients required dialysis during the first Ptx week: 216 (53.9%) in 2000, 189 (62.3%) in 2001, and 216 (51.6%) in 2002. The frequency of DGF during the study period was higher than that noted by several previous foreign studies. To better evaluate the possible causes of this finding, a more extensive and focused study is warranted. D ELAYED GRAFT FUNCTION (DGF) after kidney transplantation has a variable frequency in different centers and in various countries and regions. 1–9 DGF is an important risk factor both for patient and for graft survival. It increases morbidity, acute rejection rate, and eventual mortality. There are no data regarding the incidence of DGF in Brazil or about differences among transplant centers in various regions. PATIENTS AND METHODS A questionnaire was sent to 17 Brazilian centers which, according to Brazilian Transplantation Association Annual Report, per- formed more than 50 transplants during 2002. This arbitrary number was chosen to avoid a “center effect” from centers with less expertise. Transplant centers were asked to complete data exclu- sively about cadaveric kidney transplants: the number of trans- plants performed in 2000, 2001, and 2002; the number of patients who experienced early complications of humoral rejection, vascular thrombosis, arterial stenosis, or primary nonfunction or early patient death, are of which might prevent evaluation of DGF due to donor organ harvesting factors; as well as the number of patients who underwent dialysis during the first posttransplant week and subsequently recovered renal function. Patients under 18 years old and those with multiple organ transplants were excluded. RESULTS Six centers replied. Due to the small number of participat- ing centers it was not possible to establish regional compar- isons. The data are presented in Tables 1 and 2. They showed an early graft loss of 9.7% and DGF (excluding early graft loss) of 55.6%. When our data were analyzed by center, wide differences were noted in early graft loss (3.2% to 22.8%) or DGF rates (42.4% to 81.5%). It was not possible to establish the reason for this. The analysis of annual rate of DGF showed regularity in the frequency. No seasonal effect was noted. DISCUSSION DGF frequency reported in the literature varies widely (Tropman et al, 1 23%; Ojo et al, 2 24%; Lehtonen et al, 3 33%; Pfaf et al, 4 27%; Giral-Classe et al, 5 47%; Shoskes and Cecka, 6 24.4%; McLaren et al, 7 27.3%; Boom et al, 8 23.2%; Qureshi et al, 9 52%) as well as early graft (Lehtonen et al, 3 2.9%; Giral-Classe et al, 5 6%; McLaren et al, 7 4.1%; Boom et al, 8 3%). However, it is difficult to compare the rates of From the Hospital Clementino Fraga Filho (RJ) (R.T.G.), Hos- pital das Clinicas da Faculdade de Medicina da USP (SP) (L.S.A., M.C.R.C., L.E.I.), Hospital das Clı´nicas de Porto Alegre (RS) (R.M.), Hospital Evangélico de Curitiba (PR) (F.C.), Hospital Geral de Bonsucesso (RJ) (D.B.M.D.C.) and Hospital São Lucas da PUCRS (RS) (D.O.D.) Address reprint requests to Dr Luiz Sergio Azevedo, Unidade de Transplante Renal, Hospital das Clı´nicas da Faculdade de Medicina da Universidade de São Paulo, Av Enéas Carvalho Aguiar 255, sala 706, Caixa Postal 11.273-9, 05422-970 São Paulo-SP, Brazil. E-mail: ls.azevedo@zaz.com.br 0041-1345/05/$–see front matter © 2005 by Elsevier Inc. All rights reserved. doi:10.1016/j.transproceed.2005.05.005 360 Park Avenue South, New York, NY 10010-1710 2746 Transplantation Proceedings, 37, 2746 –2747 (2005)