Kidney graft rejection crisis: time-evolution, prognostic significance and role in infection

For 255 kidney grafts performed during the past twelve years, 622 rejection crises (RC) were analysed. Irreversible RC occurred more frequently in second than in first grafts during the first post-operative trimester. A clear relationship between long term graft tolerance and RC occurring during the first post-operative month was observed. Infection was related to RC in 61% of cases. Infections following corticosteroid therapy after short intervals were usually characterised by a poor prognosis. These clinical features have practical implications for immunosuppressive treatment.