Terlipressin reduces the incidence of delayed graft function in kidney transplant recipients

Abstract Background Delayed graft function (DGF) is the most common complication experienced by kidney transplant recipients; therefore, it is critically important to develop an effective method of reducing DGF. Terlipressin can improve kidney function in patients with hepatorenal syndrome; therefore, we hypothesized that terlipressin plays a protective role in DGF and allograft function after transplantation. Methods In this retrospective, observational cohort study, we reviewed the medical records of 362 patients who underwent kidney transplantation at our organ transplant center between February 2015 and December 2019. The eligible recipients were divided into two groups based on whether they received terlipressin (Terlipressin group; n = 162) or dopamine (Control group; n = 200) on days 0–2 post-transplantation. The association between DGF and various clinical parameters was assessed using logistic regression analyses, and linear regression analysis was performed for predicting allograft function 30 days after transplantation. Results Compared to the Control group, the Terlipressin group had a significantly lower DGF rate (14.2 vs. 23.0%, P = 0.034), a higher estimated glomerular filtration rate during the two days post-transplantation (day 1: 9.54 ± 6.90 vs. 6.35 ± 4.95 mL/min/1.73m 2 , P < 0.001; day 2: 15.35 ± 11.96 vs. 11.60 ± 10.49 mL/min/1.73 m 2 , P = 0.002), and a lower urinary tract infection rate (8.0 vs. 16.0%, P = 0.022). Terlipressin (odds ratio [OR], 0.544, 95% confidence interval [CI], 0.297–0.998, P = 0.049) and female recipient (OR, 0.366, 95% CI, 0.172–0.780, P = 0.009) were independent protective factors for DGF. DGF was negatively associated with allograft function 30 days after transplantation ( β = 130.210, 95% CI, 103.731–156.688, P < 0.001). Conclusions Terlipressin reduced the incidence of DGF in kidney transplant recipients, indicating that it could be used as a new strategy for DGF prevention.