Delayed graft function

Delayed graft function is the medical term used when a transplant doesn’t start working straight away. You may hear your care team talk about your kidney being ‘sleepy’ or slow to ‘wake up’.

Delayed graft function is very common, affecting between 20-60 in 100 of kidneys transplanted from deceased donors. The majority of kidneys do eventually start working. This is also known as your kidney ‘waking up’.

The main signs are little or no urine and high creatinine levels in your blood tests. Your transplant team will be monitoring you carefully to check for these.

If your doctors suspect you might have delayed graft function, your blood tests will be checked closely to see whether you need dialysis. Your new kidney will be scanned to look at its blood supply and to make sure that it is not blocked. If your kidney still has not ‘woken up’ after 5-7 days, your transplant team will decide whether or not your kidney needs to be sampled (‘biopsied’) to check for other problems such as rejection.

Your care team will continue to monitor your urine and the creatinine levels in your blood. You may need to restrict the salt, potassium, phosphate in your diet, and limit the amount of water you drink. Your transplant team will discuss this with you.

This varies from patient to patient. It can take days or weeks.

There a few things that could contribute to an increased risk of delayed graft function. These include: 

• Kidneys that come from older donors
• Kidneys from a donation after circulatory death (DCD) donor
• Kidneys that have spent longer in cold preservation before being transplanted
• How long you have been on dialysis - the longer it has been, the higher the risk of delayed graft function
• High levels of antibodies in your blood against tissue types also makes delayed graft function more likely