Abstract:

BACKGROUND: Delayed graft function (DGF) and chronic allograft nephropathy, rather than acute rejection, puzzle the patients following renal transplantation.
OBJECTIVE: To study the cause and the treatment of hyper DGF (HDGF) on 15 cases after renal transplantation.
METHODS: Retrospective research was performed on 15 patients with HDGF. All patients received half-dose immunosuppressant (cyclosporin A 3.0-4.0mg/kg, Tacrolimus 0.5-1 mg/kg), the dose was regulated according to plasma concentration, and hemodialysis/continuous renal replacement therapy was performed. Inducement of HDGF recovery was analyzed, and the renal functions were observed. 
RESULTS AND CONCLUSION: The cause of HDGF included hypotension, long warm ischemia time, acute rejection, calcineurin inhibitor toxicity, operate-complication, as well as atherosclerosis. The longest duration from oliguria stage to diuresis stage was 108 days, averaged 32-108 days. Eight patients survived with good graft function (averaged serum creatinine level 78-135 μmol/L), 5 patients survived with slight abnormality graft function (averaged serum creatinine level 135-300 μmol/L), and 2 patients with severe renal disfunction (serum creatinine level > 300 μmol/L). The longest follow-up was 11 years, and the graft function was normal. Early renal biopsy, early renal Doppler ultrasound, combined therapy and individualized treatment can help majority of the patients who suffered with DGF survived with normal graft function.