Graft failure and graft nephrectomy without severe complications

The courses of 34 graft failures leading to graft nephrectomy in 19 patients were examined retrospectively. Cyclosporin (CsA) was the sole immunosuppressive in 70% of the cases, and azathioprine-prednisolone in 30%. Having diagnosed graft failure, the immunosuppressive treatment was continued for about 2-3 months and then tapered slowly. No deaths related to graft failure were recorded. In three cases a delay in graft nephrectomy caused complications such as sepsis and coagulopathy. We conclude that continuing immunosuppression a few months after having diagnosed graft failure may postpone or avoid graft nephrectomy while steroid withdrawal symptoms do not complicate the course at the time of graft failure.