Introduction: Immediate outcome of renal transplantation depends upon various factors including type of organ perfusion solution used. Histidine-tryptophan-ketoglutarate (HTK) solution is now commonly used perfusion solution, but it is costly. In many developing countries, Ringer’s lactate solution has been used as a perfusion solution since the early days of transplantation, as its electrolyte content is similar to plasma and is less costly. The purpose of this study was to find out the risk factors of delayed graft function (DGF) with special attention on type of perfusion solution used.|
Methods: This was a retrospective cohort study, done from the hospital records at Dialysis and Kidney Transplant unit of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital. Total 148 live related kidney transplant recipients were included in the study. In group 1 (n = 13), Ringer’s lactate perfusion solution was used and in group 2 (n = 135), HTK solution was used.
Results: Total 148 live related kidney transplant recipient were included in this study with male predominance (male 109 and female 39). Mean age of recipients and donors were 36.48± 10.62 and 37.49± 10.06 years respectively. Regarding primary disease, hypertension and diabetes were the predominant causes of chronic kidney disease. First-degree relatives came forward to donate their kidney to their relatives. Among the recipients, 9 (6.1%) patients presented with DGF (4/13, 30.8% in Group 1 and 5/135, 3.7% in Group 2). Significant factors of DGF were lactate based perfusion fluid (p=0.004) and first-degree relatives (p=0.012). Regression analysis showed age of recipients (OR 1.100, 95% CI 1.011 - 1.197, p 0.026) and ringer's lactate perfusion fluid (OR 9.758, 95% CI 1.461 - 65.201, p 0.019) were significant risk factors for developing DGF.

Table:  Regression analysis of different variable responsible for delayed graft function (n=148)

Conclusions: Nearly six percent of live related kidney transplant recipients had DGF. Ringer's lactate perfusion fluid and older age group of recipients were the major risk factors for DGF.