Association of delayed graft function with cardiovascular outcomes in kidney transplant recipients
Abstract
Cardiovascular disease remains a major cause of morbidity and mortality in kidney transplant recipients. This multicenter cohort study examined the association between delayed graft function (DGF) and major adverse cardiovascular events (MACEs) in a cohort of 18 149 kidney transplant recipients from 17 French hospitals, transplanted between 2008 and 2022. The primary outcome measured was the incidence of MACEs, including cardiovascular death, coronary artery disease, heart failure, and stroke, with secondary outcomes of graft failure and noncardiovascular death. Among the cohort, 4182 (23.0%) experienced DGF, which was associated with a significantly increased risk of MACEs (hazard ratio: 1.24, 95% confidence interval: 1.10-1.40), particularly coronary artery disease, heart failure, and cardiovascular death, but not stroke. The association of DGF with an increased MACE incidence remained consistent over time (P-interaction = .19) and intensified with greater DGF severity, as measured by the number of dialysis sessions required after transplantation (P-trend = .01). Graft function did not significantly mediate the association between DGF and MACEs (P = .62). These findings suggest that the renal lesions resulting from DGF may mediate cardiovascular risk, highlighting the need for optimized prevention and treatment strategies to improve patient outcomes.
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BibTeX
@article{beaudrey2026association,
title = {{Association of delayed graft function with cardiovascular outcomes in kidney transplant recipients}},
author = {Thomas Beaudrey and Estelle Aymes and Olivier Thaunat and Dimitri Bedo and Christophe Masset and Vincent Pernin and Philippe Gatault and Marc Ladrière and Marie-Pascale Morin and Coralie Poulain and Antoine Thierry and Dominique Bertrand and Valérie Chatelet and Laetitia Albano and Yannick Le Meur and Anne Elisabeth Heng and Charlotte Boud’hors and Jean Philippe Rerolle and Guillaume Claisse and Sophie Caillard and Aghilès Hamroun and Nans Florens},
journal = {American Journal of Transplantation},
year = {2026},
month = sep,
doi = {10.1016/j.ajt.2025.05.036},
url = {https://hal.science/hal-05746205v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association of delayed graft function with cardiovascular outcomes in kidney transplant recipients
AU - Thomas Beaudrey
AU - Estelle Aymes
AU - Olivier Thaunat
AU - Dimitri Bedo
AU - Christophe Masset
AU - Vincent Pernin
AU - Philippe Gatault
AU - Marc Ladrière
AU - Marie-Pascale Morin
AU - Coralie Poulain
AU - Antoine Thierry
AU - Dominique Bertrand
AU - Valérie Chatelet
AU - Laetitia Albano
AU - Yannick Le Meur
AU - Anne Elisabeth Heng
AU - Charlotte Boud’hors
AU - Jean Philippe Rerolle
AU - Guillaume Claisse
AU - Sophie Caillard
AU - Aghilès Hamroun
AU - Nans Florens
PY - 2026
DA - 2026/09/11
JO - American Journal of Transplantation
DO - 10.1016/j.ajt.2025.05.036
UR - https://hal.science/hal-05746205v1
AB - Cardiovascular disease remains a major cause of morbidity and mortality in kidney transplant recipients. This multicenter cohort study examined the association between delayed graft function (DGF) and major adverse cardiovascular events (MACEs) in a cohort of 18 149 kidney transplant recipients from 17 French hospitals, transplanted between 2008 and 2022. The primary outcome measured was the incidence of MACEs, including cardiovascular death, coronary artery disease, heart failure, and stroke, with secondary outcomes of graft failure and noncardiovascular death. Among the cohort, 4182 (23.0%) experienced DGF, which was associated with a significantly increased risk of MACEs (hazard ratio: 1.24, 95% confidence interval: 1.10-1.40), particularly coronary artery disease, heart failure, and cardiovascular death, but not stroke. The association of DGF with an increased MACE incidence remained consistent over time (P-interaction = .19) and intensified with greater DGF severity, as measured by the number of dialysis sessions required after transplantation (P-trend = .01). Graft function did not significantly mediate the association between DGF and MACEs (P = .62). These findings suggest that the renal lesions resulting from DGF may mediate cardiovascular risk, highlighting the need for optimized prevention and treatment strategies to improve patient outcomes.
SN - 1600-6135
SN - 1600-6143
ER -