DGF leads to adverse outcomes, including prolonged hospital stay, need for postoperative
hemodialysis, significant increase in medical care costs, decrease in the 1-year survival rate
of graft, increase in the rejection incidence, and decrease in the long-term graft survival and
the short-term and long-term survival rate of patients. Various medical modalities may
decrease the incidence of DGF:
1. To choose young donors and ensure good match of the graft with the recipient.
2. To reduce warm and cold ischemia time.
3. To assess the graft quality and utilize optimal renal grafts.
4. To preserve renal grafts by pulsatile mechanical perfusion.
5. To administer small doses of calcineurin inhibitors (CNIs), biological
immunosuppressants and calcium channel blockers. Calcium channel blockers may
regulate the immune system and reduce acute rejection. In addition, they prevent the
toxic and adverse effects of CNIs and decrease blood pressure.
6. To maintain a proper level of mean arterial pressure in the recipient prior to graft
reperfusion.