Kidneys donated after circulatory death (DCD) perform similarly to kidneys donated after brain death (DBD). However, the respective incidences of delayed graft function (DGF) differ. This questions the donor type-specific impact of early graft function on long-term outcomes. Using competing risk and Cox-regression analysis, we compared death-censored graft loss between types of early graft function: DGF (temporary dialysis dependency started within 7 days after transplantation), slow graft function (3-day plasma creatinine decline less than 10% per day), and immediate graft function. In 1061 DBD and 1605 DCD graft recipients (January 2014 until January 2023), graft survival was similar. DGF was associated with death-censored graft loss in DBD and DCD (adjusted hazard ratios: DGF in DBD: 1.79 [1.04-2.91], P = .027, DGF in DCD: 1.84 [1.18-2.87], P = .008; Reference: no DGF). Slow graft function was associated with death-censored graft loss in DBD, but not significantly in DCD (adjusted hazard ratios DBD: 2.82 (1.34-5.93), P = .007, and DCD: 1.54 (0.72-3.35), P = .262; Reference: immediate graft function). Early graft dysfunction has a differential impact on graft outcome in DBD and DCD. The differences between DBD and DCD should be accounted for in research and the clinic.

中文翻译：

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早期移植物功能障碍对脑死亡后和循环死亡后肾脏捐献的不同影响：来自荷兰国家移植登记处的见解


循环死亡 （DCD） 后捐献的肾脏与脑死亡 （DBD） 后捐献的肾脏表现相似。然而，延迟移植物功能 （DGF） 的相应发生率不同。这质疑了早期移植物功能对长期结果的供体类型特异性影响。使用竞争风险和 Cox 回归分析，我们比较了早期移植物功能类型之间的死亡删失移植物损失： DGF （移植后 7 天内开始暂时性透析依赖）、移植物功能缓慢 （3 天血浆肌酐下降低于每天 10%）和即刻移植物功能。在 1061 例 DBD 和 1605 例 DCD 移植物受体中（2014 年 1 月至 2023 年 1 月），移植物存活率相似。DGF 与 DBD 和 DCD 中的死亡删失移植物丢失相关（调整后的风险比：DBD 中的 DGF：1.79 [1.04-2.91]，P = .027，DCD 中的 DGF：1.84 [1.18-2.87]，P = .008;参考：无 DGF）。慢移植物功能与 DBD 中死亡删失的移植物丢失相关，但在 DCD 中不显著（调整后的风险比 DBD：2.82 （1.34-5.93），P = .007，DCD：1.54 （0.72-3.35），P = .262;参考：立即移植函数）。早期移植物功能障碍对 DBD 和 DCD 的移植物结局的影响不同。DBD 和 DCD 之间的差异应在研究和临床中加以考虑。