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World J Nephrol. Sep 25, 2026; 15(3): 120809
Published online Sep 25, 2026. doi: 10.5527/wjn.120809
Clinical outcomes of deceased donor kidney transplantation: Eight years of experience from a tertiary care center in India
Taruna Pahuja, Sukhwinder S Sangha, Sushma Yadav, Arnav Aggarwal, Virinder K Bansal, Seenu Vuthaluru, Sandeep Aggarwal, Arun K Subbiah, Aarti Vij, Sanjay K Agarwal, Dipankar Bhowmik, Pearl Yadav, Raj K Yadav
Taruna Pahuja, Arun K Subbiah, Sanjay K Agarwal, Dipankar Bhowmik, Raj K Yadav, Department of Nephrology, All India Institute of Medical Sciences and Research, New Delhi 110029, Delhi, India
Sukhwinder S Sangha, Department of Nephrology, Command Hospital Chandimandir, Panchkula 134107, Haryana, India
Sushma Yadav, Department of Gynecology, Shaheed Hasan Khan Mewari Government Medical College, Nuh 122107, Haryana, India
Arnav Aggarwal, Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences and Research, New Delhi 110029, Delhi, India
Virinder K Bansal, Seenu Vuthaluru, Sandeep Aggarwal, Department of Surgical Disciplines, All India Institute of Medical Sciences and Research, New Delhi 110029, Delhi, India
Aarti Vij, Department of Hospital Administration, All India Institute of Medical Sciences and Research, New Delhi 110029, Delhi, India
Pearl Yadav, DY Patil Medical College, Pune 411018, Maharashtra, India
Co-first authors: Taruna Pahuja and Sukhwinder S Sangha.
Author contributions: Pahuja T, Yadav RK, Bhowmik D, and Agarwal SK participated in research design; Pahuja T, Sangha SS, and Yadav RK participated in the writing of the paper; Bansal VK, Vethaluru S, Aggarwal S, Subbiah AK, and Vij A participated in the performance of the research; Yadav S, Aggarwal A, and Yadav P contributed in analytic tools; Pahuja T, Sangha SS, and Yadav RK participated in data analysis.
AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Institutional review board statement: The study has been reviewed and approved by AIIMS, New Delhi, Institutional Ethics Committee (IECPG-388/20.07.2023).
Clinical trial registration statement: No intervention was carried out on subjects. CT registration was not done and hence CT registration certificate not applicable.
Informed consent statement: All study participants, enrolled prospectively or their legal guardian, provided informed written consent prior to study enrollment. It was waived off for the patients enrolled retrospectively.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at
rkyadavnephrology@gmail.com. Participants gave informed consent for data sharing.
Corresponding author: Raj K Yadav, DM, Additional Professor, FASN, Department of Neph
rology, All India Institute of Medical Sciences and Research, Ansari Nagar, New Delhi 110029, Delhi, India.
rkyadavnephrology@gmail.com
Received: March 11, 2026
Revised: May 6, 2026
Accepted: May 26, 2026
Published online: September 25, 2026
Processing time: 155 Days and 16.8 Hours
BACKGROUND
Deceased donor kidney transplantation (DDKT) remains underutilized in India due to organ shortage. Understanding determinants of transplant outcomes such as delayed graft function (DGF), graft survival and patient survival is essential to optimize patients and wisely allocate organs to best deserving patients.
AIM
To identify donor, recipient and peri-transplant determinants of DGF, graft and patient survival in DDKT.
METHODS
This is an ambispective cohort study for patients transplanted between January 2017 and September 2024. Primary outcome was incidence of DGF and predicting factors. Secondary outcomes were graft and patient survival. Logistic regression was used to analyse predicting factors for DGF and cox proportional hazards model was used to assess factors for graft and patient survival.
RESULTS
Among 62 DDKT, DGF occurred in 35.5% of DDKT recipients. While 6 factors affected DGF, only high recipient body mass index and high donor terminal serum creatinine were independent predictors of DGF. Over a median follow up of 32 months, 4 patients returned to maintenance haemodialysis and 11 patients died with functioning grafts with most events occurring within first year of transplant. Graft survival was 85.2% at 1 year and 68.2% at 4 years, while patient survival was 90.2% and 75.5%, respectively. Recipient age and kidney donor risk index (KDRI) were associated with graft loss. No factor affected mortality.
CONCLUSION
These findings highlight the importance of comprehensive donor and recipient assessment along with using KDRI or a new prediction tool for organ allocation in India. Larger multicentric studies from India are needed to further refine risk prediction models in DDKT.
Core Tip: In this ambispective study we evaluated predictors of delayed graft function (DGF), graft and patient survival in deceased donor kidney transplant programme over a period of eight years in a tertiary care centre in north India. Only high recipient body mass index and high donor terminal serum creatinine were independent predictors of DGF. High recipient and donor age, kidney donor risk index and DGF were associated with graft loss.
