ABSTRACT
The definition of delayed graft function (DGF) varies among transplant centers, although most of them classify under the term DGF those cases who require dialysis in the first week after transplantation. This definition has at least two main drawbacks: (1) there are different criteria for dialysis prescription among nephrologists, and (2) it includes both reversible and irreversible cases of acute graft failure, such as acute tubular necrosis, acute rejection, cortical necrosis, primary non-function, and hyperacute rejection. Some investigators proposed defining DGF on the basis of prognostic predictors. Park et al. (2002) found that graft survival is consistently lower in patients with a slow reduction of creatinine levels during the first 2 weeks after transplant than in patients with an immediate resumption of graft function Govani et al. (2002) proposed defining immediate graft function and DGF on the basis of the creatinine reduction ratio and 24-hour creatinine excretion from post-transplant day 1 to day 2. These criteria were validated by Rodrigo et al. (2004), who found a good correlation between the creatinine reduction ratio at post-transplant day 2 and renal function throughout the first year.
