[Risk factors for chronic allograft failure in renal transplant recipients]

To identify the potential risk factors for the development of chronic renal allograft failure in renal transplant recipients.

The data of 235 renal transplant recipients followed up for over 1 year were observed prospectively. And their risk factors were identified with multivariate Logistic regression analysis.

Forty-seven patients were diagnosed as chronic allograft failure (CAF). Multivariate risk factor analyses revealed that early (OR, 2.12; P < 0.01) and late (OR, 4.54; P < 0.001) acute rejection episodes, HLA-mismatch ( ≥ 3), HLA antibody production, viral infection, proteinuria, high serum triglyceride, recipient age (OR, 2.24; P < 0.01) and males (OR, 1.63; P < 0.05) were significant risk factors.Late acute rejection (>3 months post-transplantation) was more important than early acute rejection with regards to the development of CAF. Delayed graft function and cyclosporine concentration were not associated with the development of CAF.

Both immunologic and non-immunologic risk factors are involved in the development of CAF. Predicating the risks of developing CAF at an early stage, before any deterioration of graft function, is of vital importance for the improvement of renal allograft survival and may guide individualized therapy.