OBJECTIVE: To identify potential risk factors for the development of chronic renal allograft failure. SUMMARY BACKGROUND DATA: Chronic allograft failure (CAF) is the leading cause of late graft loss in renal transplantation. The authors studied the risk factors for the development of CAF in a single center during a period in which a consistent baseline immunosuppression regimen (cyclosporine, azathioprine, and prednisolone) was used. METHODS: Data from the Oxford Transplant Center Database were assessed on 862 renal allografts during a 10-year period. Risk factors were identified using multivariate logistic regression analysis. RESULTS: Biopsy-proven CAF occurred in 77 patients (9.2%) in the entire group. Multivariate risk factor analysis revealed that early and late acute rejection episodes, proteinuria, and serum triglycerides were significant factors. Acute rejection after 3 months was more important than early acute rejection. Serum triglyceride level and proteinuria at 1 year were both elevated in the CAF group. Male sex provided a protective effect. Serum creatinine levels at 6 months after the transplant were not predictive of the risk of developing CAF. CONCLUSIONS: These results from the largest single-center review to date suggest that both antigen-dependent and -independent factors are involved in the pathogenesis of CAF. Acute rejection at all time points has a significant impact on the development of CAF.
OBJECTIVE: To identify potential risk factors for the development of chronic renal allograft failure. SUMMARY BACKGROUND DATA: Chronic allograft failure (CAF) is the leading cause of late graft loss in renal transplantation. The authors studied the risk factors for the development of CAF in a single center during a period in which a consistent baseline immunosuppression regimen (cyclosporine, azathioprine, and prednisolone) was used. METHODS: Data from the Oxford Transplant Center Database were assessed on 862 renal allografts during a 10-year period. Risk factors were identified using multivariate logistic regression analysis. RESULTS: Biopsy-proven CAF occurred in 77 patients (9.2%) in the entire group. Multivariate risk factor analysis revealed that early and late acute rejection episodes, proteinuria, and serum triglycerides were significant factors. Acute rejection after 3 months was more important than early acute rejection. Serum triglyceride level and proteinuria at 1 year were both elevated in the CAF group. Male sex provided a protective effect. Serum creatinine levels at 6 months after the transplant were not predictive of the risk of developing CAF. CONCLUSIONS: These results from the largest single-center review to date suggest that both antigen-dependent and -independent factors are involved in the pathogenesis of CAF. Acute rejection at all time points has a significant impact on the development of CAF.
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: R J Knight; R H Kerman; M Welsh; D Golden; L Schoenberg; C T Van Buren; R M Lewis; B D Kahan Journal: Transplantation Date: 1991-02 Impact factor: 4.939
Authors: Manuel Arias; Domingo Hernández; Luis Guirado; Josep M Campistol; Jaime A Sánchez Plumed; Ernesto Gómez; Miguel A Gentil; Carlos de Santiago Journal: Clin Kidney J Date: 2013-02-03
Authors: Manuela Yepes-Calderón; Camilo G Sotomayor; Matthias Kretzler; Rijk O B Gans; Stefan P Berger; Gerjan J Navis; Wenjun Ju; Stephan J L Bakker Journal: J Clin Med Date: 2019-10-13 Impact factor: 4.241