Early Graft Dysfunction After Living Donor Kidney Transplant

Ideally, immediate graft function should be expected after living donor kidney transplantation. We present a case of early Banff 2A cellular rejection 24 hours after an ABO blood group-compatible, HLA crossmatch-negative living donor kidney transplant. We speculate that the development of acute rejection in this low-risk patient was likely due to the HLA mismatches and possible induction with basiliximab. This case report poses the question of whether more intensive induction therapy should be considered in low-risk patients with the presence of HLA mismatches and discusses the long-term allograft outcomes following early acute rejection.