Allograft rejection in kidney transplantation – A retrospective study of impact on graft and patient outcome
Background: Renal allograft rejection is a major cause of graft dysfunction, and it is a predictor of long-term allograft loss. Advances in immunosuppression have decreased the influence of acute rejection on graft survival. In this study, we assessed clinicopathological profile and immediate and lo...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Transplantation |
| Subjects: | |
| Online Access: | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2022;volume=16;issue=4;spage=371;epage=376;aulast=Shamsudheen |
| _version_ | 1797955021801783296 |
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| author | M P Shamsudheen Abid Kuchay Vijay Chander Gupta Isha Tiwari Raja Karthik Uttara Das Swarnalatha Guditi Gangadhar Taduri |
| author_facet | M P Shamsudheen Abid Kuchay Vijay Chander Gupta Isha Tiwari Raja Karthik Uttara Das Swarnalatha Guditi Gangadhar Taduri |
| author_sort | M P Shamsudheen |
| collection | DOAJ |
| description | Background: Renal allograft rejection is a major cause of graft dysfunction, and it is a predictor of long-term allograft loss. Advances in immunosuppression have decreased the influence of acute rejection on graft survival. In this study, we assessed clinicopathological profile and immediate and long-term treatment outcomes of different types of allograft rejections in our institute. Materials and Methods: We retrospectively analyzed patients who underwent renal transplantation and had biopsy-proven renal allograft rejections from January 2010 to December 2019 in our institute. Recipient–donor characteristics at the time of transplantation and graft function post transplantation were documented. Patients were followed up till graft loss or patient loss or a minimum 12-month period after rejection episode for all survived patients. Results: Allograft rejection occurred in 88/424 (20.75%) renal transplant recipients during the study period. Active antibody-mediated rejection (ABMR) was the most common type of rejection (40.9%) and was common in early posttransplant period also (54.5%). Graft dysfunction was the dominant presentation in all groups except chronic active ABMR, where heavy proteinuria was common. Chronic active ABMR was common (37.5%) in second episode of rejection. Overall graft survival, death-censored graft survival, and patient survival at the end of the study were 52.27%, 82.95%, and 69.3%, respectively. Conclusion: Renal allograft rejection decreases both graft and patient survival. Hence recommend regular surveillance for early detection and treatment. |
| first_indexed | 2024-04-10T23:26:46Z |
| format | Article |
| id | doaj.art-cea82ca26a584a1f8369e1a873ddfca4 |
| institution | Directory Open Access Journal |
| issn | 2212-0017 2212-0025 |
| language | English |
| last_indexed | 2024-04-10T23:26:46Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Transplantation |
| spelling | doaj.art-cea82ca26a584a1f8369e1a873ddfca42023-01-12T12:11:19ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252022-01-0116437137610.4103/ijot.ijot_93_21Allograft rejection in kidney transplantation – A retrospective study of impact on graft and patient outcomeM P ShamsudheenAbid KuchayVijay Chander GuptaIsha TiwariRaja KarthikUttara DasSwarnalatha GuditiGangadhar TaduriBackground: Renal allograft rejection is a major cause of graft dysfunction, and it is a predictor of long-term allograft loss. Advances in immunosuppression have decreased the influence of acute rejection on graft survival. In this study, we assessed clinicopathological profile and immediate and long-term treatment outcomes of different types of allograft rejections in our institute. Materials and Methods: We retrospectively analyzed patients who underwent renal transplantation and had biopsy-proven renal allograft rejections from January 2010 to December 2019 in our institute. Recipient–donor characteristics at the time of transplantation and graft function post transplantation were documented. Patients were followed up till graft loss or patient loss or a minimum 12-month period after rejection episode for all survived patients. Results: Allograft rejection occurred in 88/424 (20.75%) renal transplant recipients during the study period. Active antibody-mediated rejection (ABMR) was the most common type of rejection (40.9%) and was common in early posttransplant period also (54.5%). Graft dysfunction was the dominant presentation in all groups except chronic active ABMR, where heavy proteinuria was common. Chronic active ABMR was common (37.5%) in second episode of rejection. Overall graft survival, death-censored graft survival, and patient survival at the end of the study were 52.27%, 82.95%, and 69.3%, respectively. Conclusion: Renal allograft rejection decreases both graft and patient survival. Hence recommend regular surveillance for early detection and treatment.http://www.ijtonline.in/article.asp?issn=2212-0017;year=2022;volume=16;issue=4;spage=371;epage=376;aulast=Shamsudheenallograft rejectionantibody-mediated rejectiongraft survival |
| spellingShingle | M P Shamsudheen Abid Kuchay Vijay Chander Gupta Isha Tiwari Raja Karthik Uttara Das Swarnalatha Guditi Gangadhar Taduri Allograft rejection in kidney transplantation – A retrospective study of impact on graft and patient outcome Indian Journal of Transplantation allograft rejection antibody-mediated rejection graft survival |
| title | Allograft rejection in kidney transplantation – A retrospective study of impact on graft and patient outcome |
| title_full | Allograft rejection in kidney transplantation – A retrospective study of impact on graft and patient outcome |
| title_fullStr | Allograft rejection in kidney transplantation – A retrospective study of impact on graft and patient outcome |
| title_full_unstemmed | Allograft rejection in kidney transplantation – A retrospective study of impact on graft and patient outcome |
| title_short | Allograft rejection in kidney transplantation – A retrospective study of impact on graft and patient outcome |
| title_sort | allograft rejection in kidney transplantation a retrospective study of impact on graft and patient outcome |
| topic | allograft rejection antibody-mediated rejection graft survival |
| url | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2022;volume=16;issue=4;spage=371;epage=376;aulast=Shamsudheen |
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