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Acute rejection episodes and long-term transplant function.

T G Peters, G E Brannen, R Weil

    Archives of Surgery (Chicago, Ill. : 1960)
    |May 1, 1979
    PubMed
    Summary
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    Repeated kidney transplant rejections can lead to prolonged good function, with no increase in mortality. Predictive factors for successful outcomes include serum creatinine levels and time between rejection episodes.

    Area of Science:

    • Nephrology
    • Transplant Surgery
    • Immunology

    Background:

    • Acute rejection episodes are a significant concern following kidney transplantation.
    • Understanding the long-term outcomes and predictive factors for repeated rejections is crucial for patient management.

    Purpose of the Study:

    • To analyze the outcomes of repeated acute kidney transplant rejections.
    • To identify predictors of successful recovery after multiple rejection episodes.

    Main Methods:

    • Retrospective analysis of 114 kidney transplants in 108 patients from 1974-1976.
    • Utilized discriminant analysis to assess serum creatinine and creatinine clearance levels, and time intervals between rejections.

    Main Results:

    • 59% of kidneys experiencing three rejections regained prolonged good function.

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  • Repeated rejections did not elevate patient mortality rates.
  • Predictive models accurately forecast outcomes for second (20/25) and third (23/29) rejections.
  • Successful treatment of third rejections was observed in 70% of cases with serum creatinine < 2 mg/dL post-second rejection and 77% with >1 month interval between second and third rejections.

    • Conclusions:

    • Repeated acute rejection episodes in kidney transplants do not necessarily lead to poor long-term outcomes or increased mortality.
    • Serum creatinine levels and inter-rejection intervals are valuable predictors for managing subsequent rejection episodes and guiding treatment strategies.