{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:11:00Z","timestamp":1790053860589,"version":"4.0.1"},"reference-count":14,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Delayed graft function (DGF) is a major complication after kidney transplantation, affecting graft and patient survival. Although well-studied in Western populations, data from Eastern Europe are limited, and the prognostic significance of DGF severity, particularly renal replacement therapy (RRT) duration, is not well-defined. Methods: We conducted a retrospective analysis of 479 adult recipients of brain-dead donor (DBD) kidney transplants at a high-volume transplant center in Romania (2017\u20132024). DGF was defined as the need for dialysis within seven days\u2019 post-transplant. Baseline characteristics, graft function, and survival outcomes were compared between DGF and non-DGF groups. Kidney function was evaluated using the Estimated Glomerular Filtration Rate (eGFR). Patient and graft survival were assessed using Kaplan\u2013Meier curves and log-rank tests. DGF severity was stratified by RRT duration (\u226414 vs. &gt;14 days). Results: DGF occurred in 28.8% of patients (adjusted 24%). Those with DGF had a higher Body Mass Index (BMI), greater comorbidity (Charlson Index, Estimated Post-Transplant Survival (EPTS) score), longer pre-transplant dialysis, and higher Kidney Donor Profile Index (KDPI) donor kidneys. DGF was associated with lower graft survival at one, three, and five years and reduced patient survival at three and five years. Longer RRT was associated with progressively worse outcomes, with the poorest prognosis in patients needing &gt;14 days. Conclusions: Delayed graft function was significantly associated with reduced graft and patient survival. Prolonged DGF time was found to be predictive for poorer outcomes.<\/jats:p>","DOI":"10.3390\/jcm14207240","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T11:57:42Z","timestamp":1760529462000},"page":"7240","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Delayed Graft Function and Its Duration as Predictors of Medium-Term Kidney Transplant Outcomes: A Retrospective Cohort Study from an Eastern European Center"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0183-9815","authenticated-orcid":false,"given":"Oana","family":"Antal","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9255-8217","authenticated-orcid":false,"given":"Tudor","family":"Moisoiu","sequence":"additional","affiliation":[{"name":"Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania"},{"name":"Biomed Data Analytics SRL, 400696 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania"},{"name":"Doctoral School, Faculty of Medicine, University of Oradea, 410068 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina Daciana","family":"Elec","sequence":"additional","affiliation":[{"name":"Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana Milena","family":"Muntean","sequence":"additional","affiliation":[{"name":"Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgeta","family":"Horciag","sequence":"additional","affiliation":[{"name":"Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7945-5312","authenticated-orcid":false,"given":"Florina Maria","family":"Gabor Harosa","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4959-3458","authenticated-orcid":false,"given":"Vlad","family":"Pastor","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horia","family":"Iuga","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florin Ioan","family":"Elec","sequence":"additional","affiliation":[{"name":"Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania"},{"name":"Department of Urology, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hill, N.R., Fatoba, S.T., Oke, J.L., Hirst, J.A., O\u2019Callaghan, C.A., Lasserson, D.S., and Hobbs, F.D.R. 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Instrumental Variable Analysis","volume":"95","author":"Butala","year":"2013","journal-title":"Transplantation"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/20\/7240\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T12:22:37Z","timestamp":1760530957000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/20\/7240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,14]]},"references-count":14,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["jcm14207240"],"URL":"https:\/\/doi.org\/10.3390\/jcm14207240","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,14]]}}}