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What is delayed graft function (DGF)?
Your transplanted kidney is called a graft. Delayed graft function (DGF) can occur right after surgery. It means your new kidney is not working as it should and you may need dialysis. You may hear your transplant team say that the kidney is “sleepy”. This means you have delayed graft function. It takes some time for the kidney to heal from the transplant surgery. Some people may need dialysis for a while after their transplant. Up to 30% of deceased-donor kidneys and 5% of living donor kidneys may have some degree of DGF.
How is DGF treated?
The function of your new kidney is checked by creatinine levels. Your urine output is also checked. You may need dialysis or diuretics (water pills) and close watch of your kidney function. Your doctor may biopsy the kidney to check for rejection. You may have to follow salt, potassium, phosphorous, and water restrictions. The transplant team will decide when this diet plan is no longer needed. Your blood pressure, anti-rejection, and other medicines will be changed as needed.
Will my kidney recover from DGF?
Most transplanted kidneys with DGF do recover. Only 1 to 2% of all kidney transplants fail to work. At UW Health, 95% of kidney transplants are working one year after transplant. After the kidney starts working, it will work like any other transplanted kidney.
How long will DGF last?
There is no exact timeline for how long DGF will last. It will vary from patient to patient. DGF recovery is most often seen in about 7-10 days but can take up to 3-4 weeks for full DGF recovery.
What will happen after I am discharged?
You will be followed in the DGF Clinic at the UW Transplant Clinic. You will be told if you need to continue to follow a fluid restriction or special diet. You must check your weight daily and blood pressure twice each day. You will be given a urine collection device. You will measure and record how much urine you are making each day. Bring the record with you to each clinic visit. This is an important sign of your kidney starting to work. If you are being discharged with a new dialysis line, your nurse will tell you how to take care of that line.
The DGF Clinic is set up so that we can follow you closely. We will set you and your support person up in a hotel room close to the hospital. If you stay in a hotel, the cost will be covered by UW Health. If you live close to UW Health, you may be able to go home and drive back and forth to the Transplant Clinic. You will need to have a support person staying with you (either at home or in the hotel). You will need to have someone transport you to and from the clinic for your visits.
You will return to the Delayed Graft Function (DGF) Clinic up to three times a week for labs, clinic visits, and dialysis, if needed based on your labs. If you need dialysis, this will be done in the dialysis unit at the hospital.
We will also decide if your anti-rejection, blood pressure, and anemia medicines need to be changed. When you no longer need dialysis, you will be discharged from the DGF Clinic. You will return to the UW Transplant Clinic for routine follow-up visits.