scholarly journals Chronic rejection.

1994 ◽  
Vol 4 (8) ◽  
pp. S23 ◽  
Author(s):  
A J Matas ◽  
J F Burke ◽  
G A DeVault ◽  
A Monaco ◽  
J D Pirsch
Keyword(s):  
Risk Factors ◽  
Acute Rejection ◽  
Chronic Rejection ◽  
Graft Loss ◽  
Acute Rejection Episode ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Maintenance Immunosuppression ◽  
Previous Infection ◽  
Definition Of

Current immunosuppressive protocols have significantly decreased graft loss to acute rejection but have had no effect on graft loss to chronic rejection. Recently, attention has been focused on the prevention and management of chronic rejection. Centers must come to a uniform definition of this phenomenon so that studies can be compared. It is believed that the definition should include both a typical clinical course and a definitive biopsy. For kidney transplant recipients, the major risk factor for the development of chronic rejection appears to be a previous acute rejection episode. Other important risk factors include low-dose maintenance immunosuppression and previous infection. Noncompliance probably plays a role in some patients. For extrarenal transplant recipients, chronic rejection has been associated with cytomegalovirus infection and/or HLA-DR matching. Immunoregulatory processes posttransplant may modify or attenuate the development of chronic rejection. Large, prospective clinical studies are required to further elucidate risk factors and to determine the effect of intervention.

Risk Factors for Graft Loss in Pediatric Renal Transplant Recipients After Transfer of Care

2016 ◽  
Vol 26 (4) ◽  
pp. 356-364 ◽  
Author(s):  
Bethany Coyne ◽  
Patricia J. Hollen ◽  
Guofen Yan ◽  
Kenneth Brayman
Keyword(s):  
Risk Factors ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Graft Loss ◽  
National Database ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Transfer Of Care ◽  
Medication Noncompliance

Background: Improvements in transplantation have increased the survival of children after kidney transplantation. These patients have complex needs, and the current medical system is not prepared to effectively transfer the care of these individuals from pediatric to adult health-care systems. Too often, transfer occurs during moments of crisis and is associated with poor outcomes. Objective: The aim of this study was to use a national database, the Scientific Registry of Transplant Recipients, to test the hypothesis that the increased risk of graft loss after transfer of care (from pediatric to adult services) for young adult kidney transplant recipients over a 2- to 3-year posttransfer follow-up period was related to these posttransfer risk factors (medication noncompliance, acute rejection, insurance status). Design: A retrospective, longitudinal, correlational design using secondary data was used to evaluate the transfer of care of 250 kidney transplant recipients (ages 16-25). Results: Seventy-seven (30.8%) individuals lost their graft within 3 years after transfer of care. Medication noncompliance, acute rejection, and serum creatinine >2.0 mg/dL at transfer were significant predictors of graft loss after accounting for multiple other factors. Conclusion: These individuals are at risk for graft loss after transfer of care and may benefit from increased personalized care during this risky period.

scholarly journals Long-Term Outcomes among Kidney Transplant Recipients and after Graft Failure: A Single-Center Cohort Study in Brazil

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Paula Rebello Bicalho ◽  
Lúcio R. Requião-Moura ◽  
Érika Ferraz Arruda ◽  
Rogerio Chinen ◽  
Luciana Mello ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Transplantation ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Cause Of Death ◽  
Chronic Rejection ◽  
Graft Failure ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Background. The results of kidney transplantation are impacted by the categories of events responsible for patient death and graft failure. The objective of this study was to evaluate the causes of death and graft failure and outcomes after graft failure among kidney transplant recipients. Methodology. A retrospective cohort study was conducted with 944 patients who underwent kidney transplantation. Outcomes were categorized in a managed and hierarchical manner. Results. The crude mortality rate was 10.8% (n=102): in 35.3% cause of death was infection, in 30.4% cardiovascular disease, and in 15.7% neoplasia and in 6.8%, it was not possible to determine the cause of death. The rate of graft loss was 10.6%. The main causes of graft failure were chronic rejection (40%), acute rejection (18.3%), thrombosis (17.3%), and recurrence of primary disease (16.5%). Failures due to an acute rejection occurred earlier than those due to chronic rejection and recurrence (p<0.0001). As late causes of graft loss, death with the functioning kidney occurred earlier than recurrence and chronic rejection (p=0.008). The outcomes after graft failure were retransplantation in 26.1% and death in 21.4%, at a mean of 25.5 and 21.4 months, respectively. Conclusion. It was possible to identify more than 90% of the events responsible for the deaths of transplanted patients, predominantly infectious and cardiovascular diseases. Among the causes of graft failure, chronic and acute rejections and recurrence were the main causes of graft failure which were followed more frequently by retransplantation than by death on dialysis.

Correlations of Serum and Urine Levels of Neopterin, IL-8, IL-6, IL-6R, Basic Fetoprotein and Hepatocytes Growth Factor with Acute Rejection in kidney Transplantation

Pteridines ◽  
1998 ◽  
Vol 9 (1) ◽  
pp. 22-25
Author(s):  
Tsuneharu Miki ◽  
Shiro Takahara ◽  
Akihiko Okuyma
Keyword(s):  
Acute Rejection ◽  
Rejection Episode ◽  
Stable Condition ◽  
Serum Levels ◽  
Acute Rejection Episode ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Urinary Neopterin ◽  
Basic Fetoprotein ◽  
Urine Levels

Summary Levels of serum- and urinary-neopterin and serum-IL-6 and IL-6R of kidney transplant recipients "Were higher in acute rejection episode than in stable condition. IL-8 serum levels had risen prior to clinical diagnosis of acute rejection episode. Serum HGF levels also increased during acute rejection episode to over 1 ng/ml. Serum-neopterin and IL-6R levels were relatively sensitive for the detection of acute rejection episode.

scholarly journals MO995DO THE TIMELINE AND SPECTRUM OF INFECTIONS CHANGE AFTER ANTI-REJECTION THERAPY IN KIDNEY TRANSPLANT RECIPIENTS?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Arvind Krishnakumar ◽  
Selvin Sundar Raj Mani ◽  
Rizwan Alam ◽  
Manish Lalwani ◽  
Athul Thomas ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Median Time ◽  
Graft Loss ◽  
Renal Transplant Recipients ◽  
Care Hospital ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Antibody Mediated Rejection

Abstract Background and Aims The infections in kidney transplant recipients has been well defined. The timeline of infections and type of infection among patients who received anti-rejection therapy for acute rejection when compared to the patients who did not develop an acute rejection. Method Renal transplant recipients with post-transplant median follow up of four years from July 2009-June 2018 were included in a retrospective cohort study at a tertiary care hospital. Demographic characteristics, biopsy proven rejections, infections and graft and patient outcome were collected from transplant records and the hospital clinical workstation. Early and late acute rejections were defined as less than and more than 3 months respectively. The rates of various infections, type and time to develop an infection in the acute rejection group were compared with the patients who did not develop any rejection. Results A total of 794 patients underwent kidney transplant during the study with mean age of 35.5±12 years and 78% being male. Two hundred and eight four patients (35.8 %) had one or more biopsy proven rejections during the median follow up of 48 months (IQR 28,77). 213 patients (75%) developed early acute rejection (less than 3 months) while the remainder developed late acute rejection. The median time to develop the first acute rejection was 12 days (IQR 6,93.3). Majority of the patients (176, 62%) developed biopsy proven acute cellular rejection, 77 patients (27.1%) acute antibody mediated rejection and rest (10.9%) either mixed or borderline rejection who were treated. The proportion of BKV infection and infective diarrhea were more in rejection group when compared to no rejection group which was statistically significant (refer Table 1). At follow up, the patients who developed rejection had more graft loss (p value 0.010) but no increase in mortality. The predictors of infection among the patients who received anti-rejection therapy were identified. The median time to develop any infection in both groups were also compared. The spectrum of infections and outcome following early and late rejections were compared. Subgroup analysis was done to look at the eGFR, proteinuria trend, graft outcomes in patients with no rejection, rejection without any infection at follow up and rejection with any infection at follow up. The effect of type of anti-rejection therapy on spectrum of infections was also studied. Conclusion This is one of the few studies which looked at the effect of anti-rejection therapy in kidney transplant recipients. Anti-rejection treatment received post kidney transplant resulted in increased rates of BKV infection and infective diarrhea. Patients with acute rejection had more graft loss during follow up with no significant effect on mortality.

Incidence of and Risk Factors for Multiple Readmissions after Kidney Transplantation

2020 ◽  
Vol 86 (2) ◽  
pp. 116-120
Author(s):  
Jessica Schucht ◽  
Eric G. Davis ◽  
Christopher M. Jones ◽  
Robert M. Cannon
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Acute Rejection ◽  
Deceased Donor ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Unplanned readmission is often used as a surgical quality metric. A subset of kidney transplant recipients undergos multiple readmissions (MRs), although the incidence and risk factors are not well described. The aim of this study was to evaluate risk factors for MR after deceased donor kidney transplantation. All patients undergoing deceased donor kidney transplantation at a single center over a three-year period were analyzed via retrospective chart review for factors associated with MR. P values <0.05 were considered significant. Of 141 patients, the 30-day readmission rate was 26.2 per cent. MR occurred in 43 (30.5%) patients. Age, race, gender, initial organ function, and dialysis vintage were not associated with MR. Diabetic recipients, those who received basiliximab induction, those with acute rejection, and those with unplanned reoperations were at increased risk for MR. Infection was the most common reason for initial readmission in patients with MR (23.3%). One-year patient survival and death-censored graft survival were reduced for patients with MR. MRs are required for 30 per cent of kidney transplant recipients, primarily because of infection and immunologic causes. Recipients with diabetes and those who have acute rejection are at greatest risk.

Obesity in pediatric kidney transplant recipients and the risks of acute rejection, graft loss and death

2017 ◽  
Vol 32 (8) ◽  
pp. 1443-1450 ◽  
Author(s):  
Maleeka Ladhani ◽  
Samantha Lade ◽  
Stephen I. Alexander ◽  
Louise A. Baur ◽  
Philip A. Clayton ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Risk factors and prognosis of late acute rejection in Chinese kidney transplant recipients

Nephrology ◽  
2017 ◽  
Vol 22 (12) ◽  
pp. 985-992
Author(s):  
Maggie Ming Yee Mok ◽  
Maggie Kam Man Ma ◽  
Desmond Yat Hin Yap ◽  
Gavin Sheung Wai Chan ◽  
Man Fai Lam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals Decreased Acute Rejection in Kidney Transplant Recipients Is Associated with Decreased Chronic Rejection

1999 ◽  
Vol 230 (4) ◽  
pp. 493 ◽  
Author(s):  
Arthur J. Matas ◽  
Abhinav Humar ◽  
William D. Payne ◽  
Kristen J. Gillingham ◽  
David L. Dunn ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Chronic Rejection ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients
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