OBJECTIVE: To determine whether a recent decrease in the rate of acute rejection after kidney transplantation was associated with a decrease in the rate of chronic rejection. SUMMARY BACKGROUND DATA: Single-institution and multicenter retrospective analyses have identified acute rejection episodes as the major risk factor for chronic rejection after kidney transplantation. However, to date, no study has shown that a decrease in the rate of acute rejection leads to a decrease in the rate of chronic rejection. METHODS: The authors studied patient populations who underwent transplants at a single center during two eras (1984-1987 and 1991-1994) to determine the rate of biopsy-proven acute rejection, the rate of biopsy-proven chronic rejection, and the graft half-life. RESULTS: Recipients who underwent transplantation in era 2 had a decreased rate of biopsy-proven acute rejection compared with era 1 (p < 0.05). This decrease was associated with a decreased rate of biopsy-proven chronic rejection for both cadaver (p = 0.0001) and living donor (p = 0.08) recipients. A trend was observed toward increased graft half-life in era 2 (p = NS). CONCLUSIONS: Development of immunosuppressive protocols that decrease the rate of acute rejection should lower the rate of chronic rejection and improve long-term graft survival.
OBJECTIVE: To determine whether a recent decrease in the rate of acute rejection after kidney transplantation was associated with a decrease in the rate of chronic rejection. SUMMARY BACKGROUND DATA: Single-institution and multicenter retrospective analyses have identified acute rejection episodes as the major risk factor for chronic rejection after kidney transplantation. However, to date, no study has shown that a decrease in the rate of acute rejection leads to a decrease in the rate of chronic rejection. METHODS: The authors studied patient populations who underwent transplants at a single center during two eras (1984-1987 and 1991-1994) to determine the rate of biopsy-proven acute rejection, the rate of biopsy-proven chronic rejection, and the graft half-life. RESULTS: Recipients who underwent transplantation in era 2 had a decreased rate of biopsy-proven acute rejection compared with era 1 (p < 0.05). This decrease was associated with a decreased rate of biopsy-proven chronic rejection for both cadaver (p = 0.0001) and living donor (p = 0.08) recipients. A trend was observed toward increased graft half-life in era 2 (p = NS). CONCLUSIONS: Development of immunosuppressive protocols that decrease the rate of acute rejection should lower the rate of chronic rejection and improve long-term graft survival.
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Authors: P S Almond; A Matas; K Gillingham; D L Dunn; W D Payne; P Gores; R Gruessner; J S Najarian Journal: Transplantation Date: 1993-04 Impact factor: 4.939
Authors: E J Schweitzer; A J Matas; K J Gillingham; W D Payne; P F Gores; D L Dunn; D E Sutherland; J S Najarian Journal: Ann Surg Date: 1991-12 Impact factor: 12.969
Authors: S Gourishankar; R Leduc; J Connett; J M Cecka; F Cosio; A Fieberg; R Gaston; P Halloran; L Hunsicker; B Kasiske; D Rush; J Grande; R Mannon; A Matas Journal: Am J Transplant Date: 2010-01-05 Impact factor: 8.086
Authors: Arthur J Matas; Raja Kandaswamy; Abhinav Humar; William D Payne; David L Dunn; John S Najarian; Rainer W G Gruessner; Kristen J Gillingham; Lois E McHugh; David E R Sutherland Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
Authors: Maria C Haller; Michael Kammer; Alexander Kainz; Heather J Baer; Georg Heinze; Rainer Oberbauer Journal: BMC Med Date: 2017-01-12 Impact factor: 8.775