Efficacy of Induction Therapy and Its Impact on the Development of Delayed Graft Function in Kidney Transplant Recipients: a Single-Center Retrospective Analysis

Abstract

Purpose: This study aimed to evaluate the impact of two different induction therapies-Basiliximab and ATG-Fresenius (ATG-F)-on early outcomes and the development of delayed graft function (DGF) in kidney transplant recipients from living or deceased donors at a single center. Matherials and methods: A total of 33 patients over 18 years old who underwent kidney transplantation at a single center between February 2022 and February 2025 were analyzed. Body mass index (BMI), demographic data, transplant characteristics, and complications were recorded. DGF was defined as requiring dialysis within the first seven postoperative days. Statistical analyses were performed using the t-test or Mann-Whitney U test for continuous variables and the Chi-square test for categorical variables, with p<0.05 considered significant. Results: The mean age of recipients was 39.8±11.9 years; there were 10 females and 23 males. The mean BMI was 24.5±3 kg/m². Sixteen patients (14/16 Basiliximab) received living-donor kidneys, while 17 (17/17 ATG-F) received deceased-donor kidneys. Cold ischemia time was 1.1±0.2 hours for living-donor grafts versus 11.6±2.0 hours for deceased donors (p=0.001). Similarly, Pre-transplant dialysis duration was significantly longer in deceased-donor recipients (2.5±2.6 vs. 9.4±4.8 years, p=0.001). Overall, 30.3% (10/33) of patients developed DGF, predominantly in those with longer ischemia and dialysis times. Conclusion: In deceased-donor kidney transplant recipients, prolonged cold ischemia and pre-transplant dialysis duration increase the incidence of DGF. The use of ATG-F in patients with high immunologic risk appears to be beneficial and is consistent with the existing literature. However, the limited sample size makes it difficult to clarify the impact of induction therapy on DGF; therefore, larger prospective studies are needed. © 2025, Pamukkale University. All rights reserved.